NMES for Older Individuals After Total Knee Arthroplasty

疾病或受伤导致的肌肉力量下降常常导致老年人丧失功能和独立性。残疾老年人肌肉力量和功能的恢复是康复治疗的主要挑战。肌无力与损伤或年龄的病因是充分阐明。为年轻人设计的最大限度地增强力量的训练计划可能不适用于老年人，因为年轻人和老年人肌肉无力的原因和肌肉形态可能不同。这项工作的总体目标是确定基于生理和形态学的康复方案是否比传统的康复方案更有效地对抗老年人肌肉力量和功能的变化。神经肌肉电刺激（NMES）可用于改善损伤或手术后的力量和功能。本研究为探索NMES在老年人中的应用提供了动力。我们假设使用NMES来增强传统的全膝关节置换术（TKA）后老年骨关节炎患者的康复计划，将比仅使用传统康复获得更大的力量和功能增益。接受tka的老年骨关节炎患者是测试康复方案有效性的理想对象，因为这些患者几乎总是表现出明显的股四头肌无力，对传统的物理康复有抵抗力。在美国，每年有超过30万例tka用于治疗老年人的膝关节骨关节炎。神经肌肉电刺激（NMES）可用于改善损伤或手术后的力量和功能。本研究为探索NMES在老年患者中的应用提供了动力。我们认为，使用NMES来增强传统的全膝关节置换术（TKA）后老年骨关节炎患者的康复计划，将比仅使用传统康复获得更大的力量和功能增益。接受tka的老年骨关节炎患者是测试康复方案有效性的理想对象，因为这些患者几乎总是表现出明显的股四头肌无力，对传统的物理康复有抵抗力。在美国，每年有超过30万例tka用于治疗老年人的膝关节骨关节炎。因此，老年患者TKA术后的成功康复是一个重要而富有挑战性的问题。该建议的具体目的是：1)评估高水平神经肌肉电刺激作为持续强化的早期康复治疗在恢复股四头肌力量和改善原发性TKA后功能结局方面的有效性；2)确定改善股四头肌力量和功能结局的生理和形态学基础。

Reduced muscle strength from illness or injuries often leads to loss of function and independence in the elderly. The recovery of muscle strength and function in disabled elderly individuals is a major challenge in rehabilitation. The etiology of the muscle weakness with injury or age is fully elucidated. Training programs designed to maximize strength gains in young individuals may not be optimal in the elderly because the cause of the weakness and the morphology of the muscle may be different for young vs. old people. The overall goal of this work is to determine if physiologically and morphologically based rehabilitation programs are more effective than traditional rehabilitation to counter changes in muscle strength and function in older individuals. Neuromuscular electrical stimulation (NMES) may be used to improve strength and function following injury or surgery. This study provides motivation for exploring the use of NMES with the elderly. We posit that using NMES to augment a traditional rehabilitation program for elderly patients with osteoarthritis following total knee arthroplasties (TKA) will result in greater strength and functional gains than using only traditional rehabilitation. Elderly patients with osteoarthritis who undergo TKAs serve as ideal subjects for testing the effectiveness of rehabilitation programs become those patients almost always exhibit marked quadriceps weakness that is resistant to traditional physical rehabilitation. More than 300,000 TKAs are performed each year in the United States to treat osteoarthritis of the knee in older individuals. Neuromuscular electrical stimulation (NMES) may be used to improve strength and function following injury or surgery. This study provides motivation for exploring the use of NMES with the elderly, We posit that using NMES to augment a traditional rehabilitation program for elderly patients with osteoarthritis following total knee arthroplasties (TKA) will result in greater strength and functional gains than using only traditional rehabilitation. Elderly patients with osteoarthritis who undergo TKAs serve as ideal subjects for testing the effectiveness of rehabilitation programs become those patients almost always exhibit marked quadriceps weakness that is resistant to traditional physical rehabilitation. More than 300,000 TKAs are performed each year in the United States to treat osteoarthritis of the knee in older individuals. So, the successful rehabilitation of elder patients following TKA is an important and challenging problem. The specific aims of this proposal are: 1) To assess the effectiveness of high-level neuromuscular electrical stimulation is an adjunct to ongoing intensive, early rehabilitation in restoring quadriceps strength and improving the functional outcome after primary TKA, and 2) To identify the physiological and morphological bases for improvements in quadriceps strength and functional outcome.