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. 2017;69(5):1-76.
doi: 10.3138/ptc.2015-88.

Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

Ethne L Nussbaum  1   2 , Pamela Houghton  3 , Joseph Anthony  4 , Sandy Rennie  1   5 , Barbara L Shay  6 , Alison M Hoens  3
Affiliations

Neuromuscular Electrical Stimulation for Treatment of Muscle Impairment: Critical Review and Recommendations for Clinical Practice

Ethne L Nussbaum et al. Physiother Can. 2017.

Abstract
in English, French

Purpose: In response to requests from physiotherapists for guidance on optimal stimulation of muscle using neuromuscular electrical stimulation (NMES), a review, synthesis, and extraction of key data from the literature was undertaken by six Canadian physical therapy (PT) educators, clinicians, and researchers in the field of electrophysical agents. The objective was to identify commonly treated conditions for which there was a substantial body of literature from which to draw conclusions regarding the effectiveness of NMES. Included studies had to apply NMES with visible and tetanic muscle contractions. Method: Four electronic databases (CINAHL, Embase, PUBMED, and SCOPUS) were searched for relevant literature published between database inceptions until May 2015. Additional articles were identified from bibliographies of the systematic reviews and from personal collections. Results: The extracted data were synthesized using a consensus process among the authors to provide recommendations for optimal stimulation parameters and application techniques to address muscle impairments associated with the following conditions: stroke (upper or lower extremity; both acute and chronic), anterior cruciate ligament reconstruction, patellofemoral pain syndrome, knee osteoarthritis, and total knee arthroplasty as well as critical illness and advanced disease states. Summaries of key details from each study incorporated into the review were also developed. The final sections of the article outline the recommended terminology for describing practice using electrical currents and provide tips for safe and effective clinical practice using NMES. Conclusion: This article provides physiotherapists with a resource to enable evidence-informed, effective use of NMES for PT practice.

Objectif : en réponse à des demandes de conseils de physiothérapeutes pour optimiser la stimulation musculaire à l'aide de la stimulation électrique neuromusculaire (SENM), une revue, une synthèse et une extraction de données de la littérature ont été entreprises par six formateurs, cliniciens et chercheurs en physiothérapie dans le domaine des agents électrophysiques. L'objectif était de cibler des affections couramment traitées ayant fait l'objet d'une quantité suffisante d'études pour tirer des conclusions concernant l'efficacité de la SENM. Les études devaient porter sur la SENM produisant des contractions musculaires visibles et toniques. Méthodes : quatre bases de données électroniques (CINAHL, Embase, PubMed et Scopus) ont été parcourues à la recherche d'études pertinentes publiées entre la création des bases de données et mai 2015. D'autres articles ont été tirés de bibliographies de revues systématiques et de collections personnelles. Résultats : les données extraites ont été synthétisées par consensus des auteurs en vue de dresser des recommandations sur l'optimisation des paramètres et des techniques d'application de la stimulation dans le traitement de déficits musculaires associés aux affections suivantes: accident vasculaire cérébral (extrémité inférieure ou supérieure; aigu ou chronique), reconstruction du ligament croisé antérieur, syndrome fémoro-rotulien douloureux, arthrose du genou et arthroplastie totale du genou, ainsi que des maladies graves et en stade avancé. Les auteurs fournissent également un résumé des éléments clés de chaque étude incluse dans la revue. Enfin, ils recommandent une nomenclature de l'électrothérapie et présentent des conseils pour l'utilisation sécuritaire et efficace de la SENM. Conclusion : ce document constitue pour les physiothérapeutes une ressource permettant d'appuyer leur utilisation de la SENM sur des données probantes.

Keywords: critical care; orthopaedics; physical therapy modalities; rehabilitation; stroke; therapeutic electrical stimulation.

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