Quadriceps muscle strength recovery with the use of high tone power therapy after anterior cruciate ligament reconstruction: a randomized controlled trial

Abstract

Background There are no scientific reports clearly describing the effectiveness of the High Tone Power Therapy in patients after ACL reconstruction. This caused that in own research an attempt was made to present the possibilities of using the selected method of electrical stimulation in the treatment of an orthopaedic patient. The aim was to assess the effectiveness of electro stimulation of the quadriceps muscle in patients after ACL reconstruction, with the use of High Tone Power Therapy. Methods In randomized controlled trial took part thirty-five men, aged 21–50, after ACL reconstruction. The tests were carried prior to and 6 months following the ACL reconstruction. After the surgery, the patients were randomly divided into experimental group (17 patients) with the High Tone Power Therapy in rehabilitation and control group (18 patients) without the High Tone Power Therapy. Patients were subjected to 6-month rehabilitation. Research tools included the measurement of muscle strength torque, ROM, knee and thigh circumference measurements, the Lysholm and the VAS scale. Results After applying HiToP, the analysis showed a statistically significant improvement of muscle torque (p = 0.041, Es = 3.71), knee circumference (p = 0.039, Es = 1.65), thigh circumference (p = 0.049, Es = 1.26), knee extension (p < 0.001, Es = 2.20) in Experimental group compared to the control group. Only the results of the VAS scale did not differ statistically significantly both within a given group and between groups. Conclusions The results confirm the hypothesis that the use of HiToP in patients after ACLr have a beneficial effect on muscle strength, reduction of joint effusion, muscle mass gain and joint function. The assumption that HiToP significantly reduces pain levels is not supported - the results in both groups are statistically insignificant. Trial registration The research project was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR). Date of first registration 11.10.2016. Registration number: ACTRN12616001416482.

ACL Reconstruction: Which Additional Physiotherapy Interventions Improve Early-Stage Rehabilitation? A Systematic Review

“…Included studies assessed the effectiveness of Kinesio Taping (KT; three studies) [ 30 , 31 , 32 ], Whole body vibration (WHB; two studies) [ 33 , 34 ], Local Vibration Training (LVT; one study) [ 35 ], trigger point dry needling (TrPDN; one study) [ 36 ], High Tone Power Therapy (HiToP; one study) [ 37 ], alternating magnetic field (one study) [ 38 ], and app-based active muscle training program (App-Based Serious Gaming; one study) [ 39 ]. The included studies were conducted in Italy [ 32 , 34 ], France [ 31 , 35 ], Poland [ 37 , 38 ], Germany [ 33 , 39 ], Spain [ 36 ] and Turkey [ 30 ]. In this review, we included two articles published in 2021 by the same author.…”

“…In the included studies, we found a high level of heterogeneity regarding different interventions, outcomes, and measures but also imprecision of estimates, which did not allow us to undertake a detailed meta-analysis. Knee function was the most measured outcome in eight studies [ 30 , 32 , 33 , 34 , 35 , 36 , 37 , 39 ]; pain [ 30 , 31 , 32 , 36 , 37 , 39 ], ROM [ 30 , 32 , 33 , 36 , 37 , 38 ], and strength of extensor muscles [ 30 , 33 , 34 , 35 , 37 , 39 ] were evaluated in six studies; edema in five studies [ 30 , 32 , 37 , 38 , 39 ] and strength of flexor muscles in three studies [ 30 , 33 , 34 ]. A subgroup analysis with a synthesis of the outcomes is presented in Table 2 .…”

“…The studies included in the analysis ranged from 4 to 9 on the PEDro scale. According to the PEDro score, four studies [ 31 , 32 , 33 , 35 ] were considered ‘fair’, five studies [ 30 , 34 , 36 , 37 , 39 ] were ‘good’ and one study [ 38 ] was ‘excellent’; 9/10 articles were randomized (90%), but only three had a concealed allocation conducted (30%). All reported publications scored particularly poorly in the blinding of subjects, therapists and assessors, potentially resulting in a higher risk of bias.…”

“…According to the RoB 2 analysis, 22.2% of included studies [ 36 , 38 ] presented an overall ‘low risk of bias’ and 11.1% of studies [ 35 ] presented ‘high risk of bias’. We had ‘some concerns’ in overall bias in 66.7% of studies [ 30 , 32 , 33 , 34 , 37 , 39 ]. When analyzing the domains of each study individually, 100% of studies presented a ‘low risk of bias’ in the randomization process.…”

Application Value of the Workshop Practice Teaching Method Based on Target-Oriented Study Modules on the Internet in Orthopedic Rehabilitation

“…The modular teaching originates from the vocational education in European and American countries, and the competency-based education (CBE) mode and MES mode have become popular in China at present. The former focuses on the vocational ability training and the latter on the professional skill training [ 21 ]. Compared with the CBE mode, the MES mode adopted in this study more complies with the requirements of orthopedic rehabilitation in practice [ 22 – 24 ].…”