Neuromuscular stimulation of the quadriceps muscle after hip fracture: A randomized controlled trial

Objective: To study the feasibility and effect of neuromuscular stimulation on recovery of mobility after surgical fixation for hip fracture. Design: Double-blind study with stratified randomization. Setting: Home-based rehabilitation program. Participants: Twenty-four women over the age of 75 years with hip fracture. Interventions: Neuromuscular or placebo stimulation of the quadriceps muscle of the fractured leg, applied for 3 hours a day, for 6 weeks, commencing 1 week after surgery. Main Outcome Measures: Recovery of walking speed and ability, postural stability, lower-limb muscle power, and pain at 7 and 13 weeks after surgery. Results: Women in the neuromuscular stimulation group showed faster recovery of mobility. Of the women receiving stimulation, 9 of 12 recovered their prior levels of indoor mobility ability by 13 weeks compared with 3 of 12 in the placebo group (Fisher exact test, P=.046). There were no differences in recovery of walking speed in the first 7 weeks, but women in the stimulation group had greater recovery between 7 and 13 weeks (mean difference=-.13m/s; 95% confidence interval, -.23 to -.01). Conclusions: Neuromuscular stimulation at home is feasible and may be effective in speeding recovery of mobility after surgical fixation of hip fracture.