Comparison of the effects of transcutaneous electrical nerve stimulation and microcurrent electrical neuromuscular stimulation after total knee arthroplasty.
Takaya Maeda, Hideki Yoshida, Yuji Wakai and 1 others
PMID 39764296WHAT IT FOUND
After knee replacement, on top of usual physical therapy, TENS gave less walking pain and faster 10-m walking than MENS at two weeks.
MENS did not differ from electrodes only. Strength and Timed Up and Go showed no group differences.
Key findings
01Pain intensity during walking was lower in the TENS group than in the MENS and control groups at 2 weeks after surgery.
02Maximum walking speed was faster in the TENS group than in the MENS group at 2 weeks after surgery.
03Timed Up and Go and isometric knee extension strength changed over time but did not show group differences.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 35 patients were studied, and the authors say the small sample was due to influenza-related ward closures. Some outcome data were missing because of ward closures caused by influenza infections. Randomisation was by envelope method rather than a computerised system. The paper reports participant blinding only. The paper does not state which outcome was primary. The difference in 10-m maximal walking time between TENS and control at 2 weeks did not reach significance, which the authors attribute to small sample size. The MENS protocol may not have matched doses used in other work: it was 60 minutes, five times a week for two weeks, and the authors note other MENS work used up to 3 hours and 10 interventions over 10 days. The electrode position was kept the same across groups for blinding, but previous MENS work used electrodes across the surgical wound at the patella level. The paper did not assess patient-reported outcomes for daily living or quality of life.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that TENS alone caused the early walking advantage. All patients received the same surgery and conventional physical therapy, the study was small, and the MENS protocol may have been inadequate.