The Impact of Neuromuscular Stimulation on the Rehabilitation Outcomes of Patients Following Joint Replacement Surgery: A Systematic Review and Meta-Analysis

Hangxing  Sun; Dan  Wu; Chao  Lou; Jinhe  Ying; Tao  Zhang

doi:10.18502/ijph.v54i5.18628

Hangxing Sun Department of Orthopedic Surgery, NO.2 People’s Hospital of Yuhang Distract, Hangzhou, 311100, China
Dan Wu Department of Medical Examination Center, Qingyuan County People's Hospital Medical Examination Center, Qingyuan 323800, Zhejiang, China
Chao Lou Department of Orthopedic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang, China
Jinhe Ying Department of Orthopedic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang, China
Tao Zhang Department of Orthopedic Surgery, Lishui Municipal Central Hospital, Lishui 323000, Zhejiang, China

DOI: https://doi.org/10.18502/ijph.v54i5.18628

Keywords: Transcutaneous electric nerve stimulation; Joint replacement; Rehabilitation; Meta-analysis

Abstract

Background: We aimed to comprehensively evaluate the impact of neuromuscular electrical stimulation (NMES) on rehabilitation outcomes in patients following joint replacement surgery.

Methods: The systematic review and meta-analysis performed a computerized search of six databases—PubMed, Wiley Library, EMBASE, Web of Science, Cochrane Central, and PEDro—from 2009-2024, for relevant randomized controlled trials (RCTs). Two independent reviewers screened the literature, extracted data, and assessed the risk of bias according to predefined criteria. The primary outcome measures included range of Motion (ROM), pain scores, muscle strength, and functional recovery scores.

Results: Ten RCTs involving 549 participants were included in the analysis, all of which met the inclusion criteria and had a moderate to low risk of bias. NMES significantly reduced pain scores in patients following joint replacement surgery (Standardized mean differences, with high heterogeneity (I² = 82%). NMES had no significant effect on flexion range of motion (I² = 33%) and a limited impact on extension range of motion (P=0.04). NMES positively affected quadriceps strength (I² = 95%). For the Timed Up and Go (TUG) test, NMES had a small positive effect (P < 0.01), but after standardizing TUG test scores based on baseline levels, NMES had a significant positive effect (P < 0.01). NMES had a significant positive effect on the stairs climb test (P < 0.01) and on function score (P = 0.01).

Conclusion: NMES is an effective adjunctive therapy for improving joint range of motion, reducing pain, and enhancing functional recovery after joint replacement surgery, but further high-quality RCTs are needed to confirm these findings.