For Patricia Brooks, the tingling of electrical current running through her leg was preferable to the sting of physical therapy following her total knee replacement.
Brooks, participated in a clinical trial offered at Forbes Regional Hospital to determine whether electrical muscle stimulation (EMS) is as effective as standard physical therapy in helping patients recover from joint replacement surgery.
The stimulator and control groups achieved the same outcomes, but patients who used the stimulators were more satisfied with their experience, according to Michael Levine, MD, the orthopaedic surgeon who served as principal investigator for the study, the results of which were published in the March issue of the Orthopedics medical journal.
“Most patient complaints after knee surgery are about the pain, but patients absolutely hate doing the therapy,” Dr. Levine said. “With this protocol, we’ve eliminated the formal therapy sessions. Patients have to bend and straighten their knee, but there’s no strength training with weights. The stimulator basically does everything for you.”
EMS uses electrical impulses to simulate the body’s natural process of voluntary muscular contractions. When an electrical impulse is applied to the motor nerve, it prompts muscle contraction, resulting in an efficient workout with less risk of injury to joints and tendons and without cardiovascular fatigue.
With orthopedic surgery needed, Brooks decided to undergo treatment at Forbes Regional Hospital. When she had the option to try EMS in the place of post-surgical physical therapy, she was all for it. The Forrest Hills resident had her knee replacement in January and didn’t relish the idea of having to trek back and forth to physical therapy classes in the snow and cold. Instead, she was able to do stretches and EMS in the comfort of her own home.
Brooks was among 35 patients who used a neuromuscular stimulator to work out muscles. A control group of 35 patients underwent two weeks of home-based physical therapy followed by an average of four weeks of outpatient physical therapy.
The therapy, which can be likened to the sensation of a mild bee sting, causes muscles to move and twitch. Brooks said it also has a massaging effect on her muscles.
“There was some pain involved, but the longer I used it the easier it got,” Brooks said. “I came home and a few days after surgery I was going up and down steps.”
While EMS is not for everyone and many people benefit from more traditional physical therapy, the equivalent outcomes achieved by the two groups suggest that not all patients require physical therapy following knee replacements, Levine said.
“They need to do something, but not everybody needs to have a therapist work with them,” he said. “If patients are motivated to use this device, the cost savings are incredible.”
A stimulator costs approximately $400. Medicare’s reimbursement rate for a physical therapy session runs around $125 and it’s easy for patients to rack up hefty insurance copayment charges, Levine said.
After her successful surgery and rehabilitation with the stimulator, Brooks returned to her job as a nurse—working long shifts while standing—in just six weeks. She’s now retired, and is able to enjoy all the activities she loves from babysitting her grandchildren to gardening (while kneeling) to hitting the gym.