Effect of Convergence-Based Russian Current and Transcutaneous Electrical Nerve Stimulation at Quadriceps Muscles on Pain, Strength, and Performance in Persons with Anterior Cruciate Ligament Reconstruction

융복합기반 러시안전류와 경피신경전기자극이 앞십자인대재건술 환자의 넙다리네갈래근의 통증, 근력, 기능에 미치는 효과

  • Received : 2016.11.21
  • Accepted : 2017.01.20
  • Published : 2017.01.28


The purpose of This study was to compare the effect of Convergence-Based russian current(RC) and transcutaneous electrical nerve stimulation(TENS) on pain, muscle strength, function of knee who had a surgical anterior cruciate ligament reconstruction(ACLR). A total of 40 Participants divided into 2 groups, with ACLR, were assigned to russian current group(RCG) or transcutaneous electrical nerve stimulation group(TENSG). Both groups were measured by varieties of tests: visual analog scale(VAS), knee flexion & extension muscle strength, knee injury and osteoarthritis outcome score(KOOS), korean lower extremity functional scale(LEFS). Both groups has shown significant changes within the measurements of VAS, Knee Flexion & Extension muscle strength, KOOS and LEFS. The RCG had more significant increase within knee extension muscle strength, LEFS compared to TENSG. By studying this research, both interventions were effective to ACLR patients, moreover, RC was more effective for knee muscle strength and lower extremity function than the TENS.


Anterior cruciate ligament;Russian current;Transcutaneous electrical nerve stimulation;Knee joint


  1. Spindler. K. P, Wright. R. W, "Anterior Cruciate Ligament (ACL) Tear", N Engl J Med, Vol.13;359, No. 20, pp. 2135-2142, 2008.
  2. Boden. B. P, Dean. G. S, Feagin. J. A, Garrett. W. E, "Mechanisms of anterior cruciate ligament injury", Orthopedics, Vol. 23, No. 6, pp. 573-578, 2000.
  3. Y. J. Kim, J. M. Jung, J. T. Han, "Exercise Treatment of Knee Joint After Anterior Cruciate Ligament Reconstruction Operation", Journal of The Korean Society of Physical Medicine, Vol. 3, No. 1, pp. 27-37, 2008.
  4. S. O. Hong, Y. T. Kim, Y. H. Choi, J. H. Park, S. H. Kang, "Development of severity-adjusted length of stay in knee replacement surgery", Journal of Digital Convergence , Vol. 13, No. 2, pp. 215-225, 2015.
  5. Y. H. Uhm, "The Feedback Mirror Therapy in Stroke Patients Effect of Muscle Activity and Function of the Upper Extremity", Journal of digital Convergence , Vol. 13, No. 6, pp. 205-212, 2015.
  6. H. S. Choi, S. B. Jeon, "Effect of Backward Walking Training on Balance Capability and Gait Performance in Patients With Stroke", Journal of Digital Convergence, Vol. 13, No. 1, pp. 367-373, 2015.
  7. Schmitt. L. C, Paterno. M. V, Hewett. T. E, "The Impact of Quadriceps Femoris Strength Asymmetry on Functional Performance at Return to Sport Following Anterior Cruciate Ligament Reconstruction", J Orthop Sports Phys Ther, Vol. 42, No. 9, pp. 750-759, 2012.
  8. J. Y. Lee, Y. S. Moon, "Effects of Chronic Pain and Social support on Depression and Suicide in the Elderly", Journal of Digital Convergence , Vol. 13, No. 10, pp. 445-458, 2015.
  9. Palmieri-Smith. R. M, Thomas. A. C, Wojtys. E. M, "Maximizing Quadriceps Strength After ACL Reconstruction", Clin Sports Med, Vol. 27, No. 3, pp. 405-424, 2008.
  10. S. G. Baek, H. J. Choi, "The Effect of 12Weeks Complexed Lower Body Muscle-Strengthening Exercise Program on Fall Risk in Elderly women", Journal of Digital Convergence , Vol. 13, No. 10, pp. 533-539, 2015.
  11. Gyselinck. D. A, Briant. J. R, Goldstein. E. L, "The Impact of Electrical Stimulation and Exercise on Independent Static Standing Balance", University of Puget Sound Ideas, 2015.
  12. Lake. D. A, "Neuromuscular Electrical Stimulation. An Overview and its Application in the Treatment of Sports Injuries", Sports Med, Vol. 13, No. 5, pp. 320-336, 1992.
  13. T. S. Go, "Effects of Russian Current Stimulation or Progressive Resistive Exercise on Muscle Strength and Endurance change", dissertation, Yongin University, 2001.
  14. S. Y. Han, "Effects of Russian Current Stimulation on Muscle Strength and Pain in Female Patients with Knee Osteoarthritis", dissertation Daegu University, 2012.
  15. Johnson. M. I, "Transcutaneous Electrical Nerve Stimulation (TENS)", Leeds Metropolitan University, 2012.
  16. K. M. Kim, Croy. T, Hertel. J, Saliba. S, "Effects of Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Reconstruction on Quadriceps Strength, Function, and Patient-Oriented Outcomes: A Systematic Review", J Orthop Sports Phys Ther, Vol. 40, No. 7, pp. 383-391. 2010.
  17. Paternostro-Sluga. T, Fialka. C, Alacamliogliu. Y, Saradeth. T, Fialka-Moser. V, "Neuromuscular Electrical Stimulation After Anterior Cruciate Ligament Surgery", Clin Orthop Relat Res, Vol. 368, pp166-175, 1999.
  18. Snyder-Mackler. L, Delitto. A, Bailey. S. L, Stralka. S. W, "Strength of the Quadriceps Femoris Muscle and Functional Recovery after Reconstruction of the Anterior Cruciate Ligament. A prospective, randomized clinical trial of electrical stimulation", J Bone Joint Surg, Vol. 77, No. 8, pp. 1166-1173, 1995.
  19. Delitto. A, Rose. S. J, Mckowen. J. M, Lehman. R. C, Thomas. J. A, Shively. R. A, "Electrical Stimulation Versus Voluntary Exercise in Strengthening Thigh Musculature After Anterior Cruciate Ligament Surgery", Phys Ther, Vol. 68, No. 5, pp. 660-663, 1988
  20. Thomas. C. W, "The efficacy of Neuromuscular Electrical Stimulation for Muscle-Strength Augmentation", Athl Ther Today, Vol. 12, No. 1, pp. 39-42, 2007.
  21. Cetin. N, Aytar. A, Atalay. A, Akman. M. N, "Comparing Hot Pack, Short-Wave Diathermy, Ultrasound, and TENS on Isokinetic Strength, Pain, and Functional Status of Women with Osteoarthritic Knees: A Single-Blind, Randomized, Controlled Trial", Am J Phys Med Rehabil, Vol. 87, No. 6, pp. 443-451, 2008.
  22. J. Y. Choe, "Reliability of Visual Analog Scale in Assessment of Acute Pain", The Journal of Korean Academic Society of Nursing Education, Vol. 9, No. 1, pp. 136-143, 2003.
  23. Ferraz. M. B, Quaresma. M. R, Aquino. L. R, Atra. E, Tugwell. P, Goldsmith. C. H, "Reliability of Pain Scales in the Assessment of Literate and Illiterate Patients with Rheumatoid Arthritis", J Rheumatol, Vol. 17, No. 8, pp. 1022-1024, 1990
  24. Bijur. P. E, Silver. W, Gallagher. E. J, "Reliability of the Visual Analog Scale for Measurement of Acute Pain", Acad Emerg Med, Vol. 8, No. 12, pp. 1153-1157, 2001.
  25. J. G. Yoon, "The Relationship between Personality, Music Type and MVIC, Power for the Knee Extensor on Inducing Muscle Fatigue", Journal of the Korean Society of Physical Medicine, Vol. 8, No. 4, pp.593-600, 2013.
  26. S. S. Seo, K. C. Chung, Y. B. Kim, "Assessment of Validity, Reliability and Responsiveness of Korean Knee Injury and Osteoarthritis Outcome Score (KOOS) for the Knee Injury", The Journal of the Korean Orthopaedic Association, Vol. 41, No. 3, pp. 441-453, 2006.
  27. Roos. E. M, Roos. H. P, Lohmander. L. S, Ekdahl. C, Beynnon. B. D, "Knee Injury and Osteoarthritis Outcome Score (KOOS)-Development of a Self-Administered Outcome Measure", J Orthop Sports Phys Ther, Vol. 78, No. 2, pp. 88-96, 1998.
  28. K. W. Lee, K. S. Jung, H. D. S대, Y. J. Jung, "Reliability and Validity of the Korean version of Lower Extremity Functional Scale in patients with lower-extremity musculoskeletal dysfunction", Journal of Special Education & Rehabilitation Science, Vol. 50, No. 3, pp.451-467, 2011.
  29. Binkley. J. M, Stratford. P. W, Lott. S. A, Riddle. D. L, "The Lower Extremity Functional Scale (LEFS): Scale Development, Measurement Properties, and Clinical Application", North American Orthopaedic Rehabilitation Research Network, Phys Ther, Vol. 79, No. 4, pp.371-383, 1999.
  30. Secrist. E. S, Freedman. K. B, Ciccotti. M. G, Mazur. D. W, Hammoud. S, "Pain Management After Outpatient Anterior Cruciate Ligament Reconstruction A Systematic Review of Randomized Controlled Trials", Am J Sports Med, Vol. 44, No. 9, pp. 2435-2447, 2016.
  31. S. Y. Han, "Effect of Rehabilitation Exercise and Neuromuscular Electrical Stimulation on a Visual Analysis Scale and on Functional Capacity Performed for 8-weeks in a Patient With Patellofemoral Pain Syndrome", Phys Ther Korea, Vol. 11, No. 3, pp. 33-42, 2004.
  32. Y. S. Jin, T. G. Jeong, "Effects of Neuromuscular Electrical Stimulation of the Vastus Medialis on Pain and Muscle Function in Patients with Knee Osteoarthritis", The Journal of the Korea Contents Association, Vol. 12, No. 1, pp. 329-337, 2012.
  33. Fitzgerald. G. K, Piva. S. R, Irrgang. J. J, "A Modified Neuromuscular Electrical Stimulation Protocol for Quadriceps Strength Training Following Anterior Cruciate Ligament Reconstruction", J Orthop Sports Phys Ther, Vol. 33, No. 9, pp. 492-501, 2003.
  34. Collins. N. J, Prinsen. C. A, Christensen. R, Bartels. E. M, Terwee. C. B, Roos. E. M, "Knee Injury and Osteoarthritis Outcome Score (KOOS): systematic review and meta-analysis of measurement properties", Osteoarthritis and Cartilage, Vol. 24, No. 8, pp. 1317-1329, 2016.
  35. Mintken. P. E, Carpenter. K. J, Eckhoff. D, Kohrt. W. M, Stevens. J. E, "Early Neuromuscular Electrical Stimulation to Optimize Quadriceps Muscle Function Following Total Knee Arthroplasty: A Case Report", J Orthop Sports Phys Ther, Vol. 37, No. 7, pp. 364-371, 2007.
  36. C. S. Lee, Y. K. Gwon, B. Y. Kim, "The Effects of 8weeks Isokinetic Exercise on Torque Variables of Knee Joint in Anterior Cruciate Ligament Patient Women", Journal of Sport and Leisure Studies, Vol. 34, No. 2, pp. 975-984, 2008.
  37. Tagesson. S, Oberg. B, Good. L, Kvist. J, "A Comprehensive Rehabilitation Program With Quadriceps Strengthening in Closed Versus Open Kinetic Chain Exercise in Patients With Anterior Cruciate Ligament Deficiency A Randomized Clinical Trial Evaluating Dynamic Tibial Translation and Muscle Function", Am J Sports Med, Vol. 36, No. 2, pp. 298-307, 2008.
  38. Bruce-Brand. R. A, Walls. R. J, Ong. J. C, Emerson. B. S, O'Byrne. J. M, Moyna. N. M, "Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial", BMC Musculoskelet Disorders, Vol. 3, No. 13, pp. 118, 2012.
  39. Arvidsson. I, Eriksson. E, "Postoperative TENS pain relief after knee surgery: objective evaluation", Orthopedics, Vol. 9, No. 10, pp. 1346-1351, 1986.
  40. Hopkins. J. T, Ingersoll. C. D, Edwards. J, Klootwyk. T. E, "Cryotherapy and Transcutaneous Electric Neuromuscular Stimulation Decrease Arthrogenic Muscle Inhibition of the Vastus Medialis After Knee Joint Effusion", J Athl Train, Vol. 37, No. 1, pp. 25-31, 2002.
  41. Shivakumar. H. B, Jayaram. M, Sharath. U. R, Sanjay. J. U, "A Comparative Study Between The Efficacy Of NMES and Quadriceps Isometric Exercises Versus TENS and Quadriceps Isometric Exercises In Patients Suffering FROM Acute Knee Osteoarthritis", J of Evolution of Med and Dent Sci, Vol. 3, No. 17, pp. 4516-4524, 2014.
  42. Sandkuhler. J, "Long-Lasting Analgesia following TENS and Acupuncture: Spinal Mechanisms beyond Gate Control", Proceedings of the 9th World Congress on Pain (Progress in Pain Research and Management), Vol. 16, No. 36, pp. 359-369, 2000.