This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Over 500,000 joint arthroplasties are performed each year in the United States to alleviate pain and disability associated with osteoarthritis, the majority of which are total knee and total hip arthroplasties. While total knee replacements reliably reduce pain and improve function in patients with knee osteoarthritis, muscle strength and function still lag behind healthy, age-matched adults years after surgery. The muscle weakness that persists indefinitely after surgery predisposes these patients to greater disability later in life. Recent investigations have found over a 60% decrease in thigh muscle force 3-4 weeks after surgery compared to before surgery, despite daily rehabilitation beginning the day after surgery. The vast majority of the force loss is attributable to decreased thigh muscle activation and muscle size, although activation deficits account for twice as much of the force loss. Neuromuscular electrical stimulation (NMES) offers an innovative approach to potentially override activation deficits and improve muscle force after surgery. Early application of NMES immediately after surgery may offer the greatest promise for decreasing muscle force loss within the first month after surgery.
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