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Neuromuscular Electrical Stimulation Use in Transtibial Amputations

Peterson, Sara and Wang, Hongwu and Miknevich, Mary Ann and Piva, Sara and Cooper, Rory A and Koontz, Alicia M (2018) Neuromuscular Electrical Stimulation Use in Transtibial Amputations. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Individuals with amputations experience an invasive surgery compromising the residual limb resulting in detriments such as a decrease in muscle strength, muscle atrophy, pain and gait impairments. Neuromuscular Electrical Stimulation (NMES) has been shown to improve the strength and volume of the quadriceps muscles in individuals who have experienced a total knee arthroplasty, osteoarthritis of the knee, anterior cruciate ligament repair and in individuals who suffer from a chronic illness. NMES has also been shown to decrease pain in conditions such as knee osteoarthritis, chronic back pain, and total knee arthroplasty. We proposed a novel idea to apply NMES to individuals with amputation to see if we can achieve the same results. The purpose of this study was to demonstrate the efficacy of NMES for individuals with a transtibial amputation. We aimed to demonstrate that when compared to a control group, individuals who received three months of NMES intervention will show greater knee extension strength, increased volume of the residual limb, decreased chronic and phantom pain and improved gait relative to the baseline measures. We also evaluated the feasibility of this intervention and determined effect sizes to power a larger study. Twenty unilateral transtibial participants who were greater than one-year post amputation were recruited and randomized into two groups. The study consisted of a baseline visit and four follow up visits. Changes in outcomes were examined between baseline and 12 weeks using a Mann-Whitney U test and box and scatterplots. Fifteen subjects completed the study. The data showed no statistical significant changes in all the outcomes except for a significant decrease in residual limb pain at 12 weeks (p=0.03). Clinically significant changes in various outcome measures were found for some individual participants. Although the study findings were inconclusive participants felt that their strength and residual limb shape improved with the NMES intervention and that the NMES was very easy to use. This pilot study demonstrated feasibility and excellent compliance with an at-home NMES intervention. A future study involving refined measurement techniques and testing with a larger cohort of transtibial amputees is warranted.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Peterson, Saraspeterson@pitt.eduSPETERSON
Miknevich, Mary
Piva, SaraspivaSPIVA
Cooper, Rory Arcooper@pitt.eduRCOOPER
Koontz, Alicia Makoontz@pitt.eduAKOONTZ
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairKoontz, Alicia Makoontz@pitt.eduAKOONTZ
Committee MemberCooper, Rory Arcooper@pitt.eduRCOOPER
Committee MemberPiva, SRspiva@pitt.eduSPIVA
Committee MemberWang,
Committee MemberMiknevich, Mary
Date: 18 July 2018
Date Type: Publication
Defense Date: 22 May 2018
Approval Date: 18 July 2018
Submission Date: 19 June 2018
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Number of Pages: 260
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: transtibial, neuromuscular electrical stimulation, amputation
Date Deposited: 18 Jul 2018 15:36
Last Modified: 18 Jul 2023 05:15

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