Journal of Sports Science and Medicine
Journal of Sports Science and Medicine
ISSN: 1303 - 2968   
Ios-APP Journal of Sports Science and Medicine
Androit-APP Journal of Sports Science and Medicine
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©Journal of Sports Science and Medicine (2022) 21, 91 - 103   DOI: https://doi.org/10.52082/jssm.2022.91

Research article
Early Superimposed NMES Training is Effective to Improve Strength and Function Following ACL Reconstruction with Hamstring Graft regardless of Tendon Regeneration
Luciana Labanca1, Jacopo E. Rocchi2, Silvana Giannini2, Emanuele R. Faloni2, Giulio Montanari2, Pier Paolo Mariani1,2, Andrea Macaluso1,2, 
Author Information
1 Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Rome, Italy
2 Villa Stuart Sport Clinic-FIFA Medical Centre of Excellence, Rome, Italy

Andrea Macaluso
‚úČ MD, PhD Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Piazza Lauro De Bosis 6, 00135, Roma, Italy
Email: andrea.macaluso@uniroma4.it
Publish Date
Received: 25-11-2021
Accepted: 28-12-2021
Published (online): 10-01-2022
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ABSTRACT

The study aimed at investigating the effects of neuromuscular electrical stimulation superimposed on functional exercises (NMES+) early after anterior cruciate ligament reconstruction (ACLr) with hamstring graft, on muscle strength, knee function, and morphology of thigh muscles and harvested tendons. Thirty-four participants were randomly allocated to either NMES+ group, who received standard rehabilitation with additional NMES of knee flexor and extensor muscles, superimposed on functional movements, or to a control group, who received no additional training (NAT) to traditional rehabilitation. Participants were assessed 15 (T1), 30 (T2), 60 (T3), 90 (T4) and at a mean of 380 days (T5) after ACLr. Knee strength of flexors and extensors was measured at T3, T4 and T5. Lower limb loading asymmetry was measured during a sit-to-stand-to-sit movement at T1, T2, T3, T4 and T5, and a countermovement-jump at T4 and T5. An MRI was performed at T5 to assess morphology of thigh muscles and regeneration of the harvested tendons. NMES+ showed higher muscle strength for the hamstrings (T4, T5) and the quadriceps (T3, T4, T5), higher loading symmetry during stand-to-sit (T2, T3, T4, T5), sit-to-stand (T3, T4) and countermovement-jump (T5) than NAT. No differences were found between-groups for morphology of muscles and tendons, nor in regeneration of harvested tendons. NMES+ early after ACLr with hamstring graft improves muscle strength and knee function in the short- and long-term after surgery, regardless of tendon regeneration.

Key words: Resistance training, semitendinosus, electrical stimulation, knee, rehabilitation


           Key Points
  • For the first time, we have studied the effects of an innovative training intervention on muscle strength, morphology and knee function in a group of patients showing deficits due to degeneration of the semitendinosus muscle, which occurs following ACL reconstruction.
  • Adding a two-month structured resistance-training intervention, based on neuromuscular electrical stimulation superimposed on functional movements, in the early phase following ACL reconstruction with hamstring graft, improves muscle strength and knee function both in the short and the long term.
  • Patients undergoing the NMES- based strength training intervention show improvements in muscle strength and function regardless of tendon regeneration.
 
 
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