Knee Injuries Clinical Trial
Official title:
Effects of Low Frequency Neuromuscular Electrical Stimulation Applied to the Quadriceps in the Production of Knee Extension Strength and Control of Edema After Anterior Cruciate Ligament Reconstruction
The anterior cruciate ligament (ACL) is frequently injured, and it is the structure of the
athlete´s knee which has the highest prevalence of reconstruction. Given this postoperative
ACL reconstruction scenario the investigator find in literature the effectiveness of
neuromuscular electrical stimulation (NMES) as an adjuvant treatment for strengthening the
quadriceps muscle. The intensity of NMES and the training duration are important factors for
a successful treatment.
The purpose of this study is to compare two rehabilitation protocols in patients during the
post operative of the ACL reconstruction over the strength of knee extension and control of
edema.
It will be a randomized controlled study with the CONSORT bases with 40 participants that
will be divided into two groups: Control group that will be submitted only to physical
therapy exercises, and the Intervention group that will be submitted to physical therapy
exercises plus electrical stimulation (low frequency device with a current of 47 Hz with
symmetrical, biphasic and pyramidal waveforms, with pulse duration of 1.5 s and interval of
1.8 s). The procedure will last six weeks. It will be evaluated the pre intervention
quadriceps muscle extension force by means of a manual dynamometer, and the joint swelling
through the perimeter. This procedure will be repeated after six weeks of intervention.
Participants Twenty-two patients that submitted to ACL surgical reconstruction with flexor
grafts less than 15 days previously will be included in the study, both genders, between
18-45 years old. Individuals with previous knee lesions, other ligament injuries,
osteochondritis or associated menisci repair and complications during surgery will not be
included in the study. Patients that carried out complimentary therapies to the proposed
treatment will be excluded.
The participants will be randomized into two groups: control and electrical stimulation
group
. Intervention All the subjects will be submitted to physiotherapy sessions three times a
week, following a 12 weeks criterion based reahabilitation, carried out in line with the
objectives proposed for each rehabilitation phase (immediate post-operative, early
post-operativeand late post-operative). A group of trained physiotherapists will design the
exercises and determinate their evolution, including range of motion improvement, muscular
control and strength, gait training with progression in weight bearing and sensory-motor
control training, according to the established guidelines.
The patients from the electrical stimulation group will receive, in addition, NMES
application in the first six weeks of treatment, using an electrical stimulator with a
carrier frequency of 47 Hz with symmetrical, biphasic and pyramidal waves, with pulse
duration of 150 µs and duty cycle of 1,5 sec on and 1,8 sec off.
Evaluation It will be evaluated the pre intervention quadriceps muscle extension force by
means of a manual dynamometer, and the joint swelling through the perimeter. This procedure
will be repeated after six weeks of intervention.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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