神经肌肉电刺激对人工全膝置换术后患者康复效果的Meta分析OA

Objective To evaluate the effect of neuromuscular electrical stimulation(NMES)on pain,quadriceps strength and motor function of patients after total knee arthroplasty(TKA). Methods The databases of CNKI,Wanfang data,VIP,PubMed,Embase,Cochrane,Web of Science and Scopus were re-trieved from inception to April,2025.Randomized controlled trials(RCT)related to the intervention of NMES after TKA were collected.The quality of the included literature was evaluated using the Cochrane Risk of Bias Assessment Tool and the Physical Therapy Evidence Database(PEDro)scale.Meta-analysis was performed with RevMan 5.4. Results A total of twelve RCT were included,involving 772 subjects.The PEDro scale score ranged from four to seven.NMES improved postoperative quadriceps muscle strength(SMD=0.61,95％CI 0.34 to 0.88,P<0.001)and knee flexion range of motion(SMD=1.35,95％CI 0.30 to 2.41,P=0.010),and reduced the Timed Up and Go Test(TUGT)time(SMD=-0.86,95％CI-1.45 to-0.26,P=0.005).Compared with the control group,the in-tervention group achieved better outcomes in the 2-Minute Walk Test(2MWT)(SMD=19.44,95％CI 10.44 to 30.43,P<0.001),3-Minute Walk Test(SMD=23.57,95％CI 14.77 to 32.36,P<0.001),6-Minute Walk Test(SMD=42.29,95％CI 9.71 to 74.86,P=0.010),Western Ontario and McMaster Universities Osteoarthritis In-dex(WOMAC)(SMD=-0.52,95％CI-1.00 to-0.04,P=0.040),as well as the Physical Component Summary(PCS)(SMD=2.90,95％CI 0.73 to 5.06,P=0.009)and Mental Component Summary(MCS)(SMD=2.84,95％CI 1.40 to 4.28,P=0.040)of the 36-Item Short Form Health Survey(SF-36).Subgroup analysis demonstrat-ed that two to four weeks after surgery,NMES enhanced patients'quadriceps muscle strength(SMD=0.90,95％CI 0.58 to 1.21,P<0.001),shortened TUGT time(SMD=-1.28,95％CI-2.57 to-0.02,P<0.05)and in-creased walking distance in 2MWT(SMD=20.43,95％CI 10.44 to 30.43,P<0.001).For patients followed up for two to three months,NMES yielded improvements in WOMAC scores(SMD=-0.44,95％CI-0.79 to-0.09,P=0.010)and SF-36 MCS scores(SMD=4.17,95％CI 2.43 to 5.91,P<0.001). Conclusion NMES can significantly improve the quadriceps strength and walking ability of the TKA patients two to four weeks after surgery,and enhance the quality of life of patients two to three months after surgery.