Strengthening Quadriceps Muscles with Neuromuscular Electrical Stimulation Following Total Hip Replacement: a Review

Purpose of Review Functional recovery from total hip replacement can be suboptimal and deficits in quadriceps muscle strength may hinder the return to activities of daily living. Neuromuscular electrical stimulation (NMES) devices have long been used to preserve and restore skeletal muscle mass and function following periods of muscle atrophy due to immobilisation. Here, we evaluate the potential role of NMES for strengthening the quadriceps muscles following hip replacement. Recent Findings Two studies have investigated the effects of NMES on quadriceps strength following hip replacement. NMES in addition to exercise training is reported to reduce length of stay and improve gait speed, stair climbing performance and sit-to-stand scores in one study. Conversely, the other study reports no significant effect of NMES on length of stay or gait speed, but instead, benefits to knee extensor strength of the operated side, functional status and independence. The benefits of NMES for the treatment of atrophic musculature following knee replacement are better established. Summary Although it is not possible to offer best-practice recommendations for clinical rehabilitation, the promising approach of NMES following total hip replacement requires further investigation. When used as an adjunctive treatment to standard care physiotherapy, NMES may facilitate recovery and, when used immediately post-surgery, can enable a high exercise volume, with little effort, at a time point where muscle inhibition and atrophy are most prevalent.