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Electrical Stimulation Could Zap the Need for Some Physical Therapy

A study completed at Forbes Regional Hospital in Monroeville could lead to physical therapy sessions being replaced with a device you would use in your home.

The study was done to see if electrical muscle stimulation, or EMS, is as effective as standard physical therapy in helping patients recover from joint replacement surgery.

Dr. Michael Levine, the principal investigator, said he wanted to have an alternative treatment for patients.

“The reason is that the biggest complaint I get from patients after total knee (replacement) is the rehabilitation: It’s really difficult, and it’s a lot of hard work, and a lot of patients just don’t like to do it,” he said.

EMS uses electrical impulses to stimulate the body’s natural process of voluntary muscular contractions. When an electrical impulse is applied to the motor nerve, it prompts muscle contraction, resulting in a workout with less risk of injury, without muscle fatigue, and with pain equivalent to a mild bee sting.

“The way they used it is in the morning," Levine said. "They did a strengthening program, and in the afternoon they did what’s called active recovery, which is what we call a TENS (Transcutaneous Electrical Nerve Stimulation), or a pain-relieving mode.”

One group of patients underwent conventional physical therapy for six to 10 weeks after leaving the hospital. The other group met with a physical therapist for range of motion exercises at the hospital but did the remaining rehab at their homes through an EMS device. According to Levine, the EMS therapy occurred for 14 days prior to surgery and for 60 days afterward.

Levine said tests of results of both programs at six weeks and at six months after the surgeries showed both processes performed well.

“The idea was to see if one group was not inferior to the other, and we actually proved that the (EMS) group was not inferior to the physical therapy group,” he said.

Another potential benefit from the new therapy is the cost. While a current EMS device costs around $400 to purchase, Levine said an upcoming device would cost around $200-$250. Levine added physical therapy is “maybe three to four times more expensive than the (EMS) device.”

Despite EMS’ low cost, Levine isn’t suggesting the end of the physical therapist is near. 

“Some people won’t even do their range of motion exercises, that need a coach, so to speak,” he said. “And those people, they’re the ones that need a (physical) therapist.”