Sanid. mil. 2015; 71 (4) 239 REVISIÓN Effectiveness of neuromuscular electrical stimulation in the functional knee rehabilitation in soldiers Castillo-Lozano R.1 Sanid. mil. 2015; 71 (4): 239-246; ISSN: 1887-8571 SUMMARY Background: The versatility of military physical therapist practice enables them not only to diagnose knee injuries but also to provide a wide range of definitive care and rehabilitation, reducing the need for costly evacuation. The aim this study was to evaluate the effective-ness of interventions by Neuromuscular Electrical Stimulation (NMES) in the functional knee rehabilitation in soldiers and describe the main predictors and determinants in each intervention. Methods: A systematic search of the literature about NMES in physiotherapy was performed using the following electronic databases: Web of Science, PubMed, Cochrane, Physiotherapy Evidence Database (PEDro) and CINAHL. The search strategy was: “neuromuscular electrical stimulation” and “physical therapy” and “strengthening” and “knee”. Inclu-sion criteria were: original articles published and peer reviewed between 2004-2015, focusing on physiotherapy interventions by NMES on subjects older than 18 years. A total resulting from 46 studies was included in the study. Results: The results show the evidence on the effec-tiveness of NMES therapeutic/preventive purposes in the muscular system; and the importance of physical therapy in the army. Conclusion: As a method of functional knee rehabilitation, NMES proves effective in achieving the therapeutic/preventive objectives in soldiers. Level of Evidence: II. Systematic review of randomized clinical trials with homogeneity. KEYWORDS: Physical Therapy, Neuromuscular Electrical Stimulation, Strengthening, Knee. Eficacia de la estimulación eléctrica neuromuscular en la rehabilitación funcional de rodilla en soldados RESUMEN: Antecedentes: La versatilidad de la práctica de la fisioterapia militar nos permite no sólo el diagnóstico de lesiones de ro-dilla sino también para proporcionar una amplia gama de atención específica y rehabilitación, reduciendo la necesidad de una evacuación costosa. El objetivo de este estudio fue comparar la eficacia de las intervenciones de estimulación eléctrica neuromuscular (NMES) en la rehabilitación de rodilla funcional en soldados y describir los principales predictores y determinantes en cada intervención. Métodos: Se realizó una búsqueda sistemática de la literatura sobre la NMES en fisioterapia utilizando las siguientes bases de datos electrónicas: Web of Science, PubMed, Cochrane, Fisioterapia Evidence Database (PEDro) y CINAHL. La estrategia de búsqueda fue: “neuromuscular electrical stimulation” and “physical therapy” and “strengthening” and “knee”. Se seleccionaron artículos originales publicados y revisados por pares entre 2004-2015, centrándonos en las intervenciones de fisioterapia mediante NMES en sujetos mayores de 18 años. Un total resultante de 46 estudios se incluyeron en el estudio. Resultados: Los resultados muestran la evidencia sobre la eficacia de los propósitos terapéuticos y preventivos de la NMES en rodilla; y la importancia de la fisioterapia en el ejército. Conclusión: La fisioterapia mediante su método NMES de rehabilitación de la rodilla resulta eficaz en el logro de los objetivos terapéuticos / preventivas en los soldados. Nivel de Evidencia: II. Revisión sistemática de ensayos clínicos aleatorizados, con homogeneidad. PALABRAS CLAVE: Fisioterapia, estimulación eléctrica neuromuscular, Fortalecimiento, rodilla. INTRODUCTION Military physical therapists have established a long and res-pected tradition of setting the highest clinical practice standards in caring for military beneficiaries (active duty, dependents of active duty, retired, and dependents of retired), the example of which has been used to help develop the physical therapy profession as a who-le. Practice standards continue to advance through emerging eviden-ce, newer technology, more informed practice, and evidence-based guidelines1. The impact of physical therapists on improving the health and military readiness of service members has garnered the support of the military’s medical leadership to such a degree that they are regu-larly credentialed by local military hospitals and health care facilities with clinical privileges to: safely examine patients with and without physician referral; order diagnostic imaging; order laboratory tests; refer patients to other practitioners; initiate duty limitations; and perform electromyographic and nerve conduction studies1-6. Mili-tary physical therapists are often the first credentialed health care provider in the process of care to diagnose and treat patients with musculoskeletal injuries. Direct access to military physical thera-pists for treatment of patients with musculoskeletal conditions has proven to be effective, with minimal risk3,4,7. Obviously, combat is not an athletic pursuit; however, the cons-truct of treating service members as athletes provides many strategic advantages. Specifically, treating service members as tactical athle-tes provides a value model for preventing and treating musculoske- 1 Lecturer. University of Osuna. Physiotherapy Department. Sevilla. Spain. Address correspondence: romu_castillo@hotmail.com // romualdocl@euosuna.org Recibido: 28 de junio de 2015 Aceptado: 15 de julio de 2015
Revista de Sanidad Militar de las FAS 71_4
To see the actual publication please follow the link above