Physiotherapy Management After Total Knee Replacement Using NMES and Stationary Cycling: A Case Report

Talitha Qanitah; Agus Widodo; Astuti

doi:10.24843/mifi.000001781

Authors

Talitha Qanitah Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia Author
Agus Widodo Department of Physiotherapy, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia Author
Astuti Department of Medical Rehabilitation, Ibu Fatmawati Soekarno General Hospital, Surakarta, Central Java, Indonesia Author

DOI:

https://doi.org/10.24843/mifi.000001781

Keywords:

Arthroplasty, Replacement, Knee, Osteoarthritis, Electric Stimulation Therapy, Muscle Strength, Rehabilitation

Abstract

Background: Patients undergoing total knee replacement (TKR) commonly experience postoperative pain, reduced muscle strength, limited joint range of motion, and impaired functional ability. Physiotherapy interventions are essential to support functional recovery.

Objective: To describe clinical outcomes following physiotherapy management using neuromuscular electrical stimulation (NMES) and stationary cycling in an elderly patient after TKR.

Methods: This case report was developed in accordance with CARE guidelines and involved a 75-year-old female patient three months after left TKR due to osteoarthritis. The intervention consisted of NMES (50 Hz, approximately 15 minutes) and stationary cycling (10–15 minutes) over three therapy sessions. Outcomes were assessed using the Numeric Rating Scale (NRS), range of motion (ROM), Manual Muscle Testing (MMT), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analyzed descriptively using absolute changes.

Results: Movement pain decreased from NRS 6 to 2, and tenderness decreased from 2 to 1. Active knee ROM improved from −20°–0°–120° to −10°–0°–130°. Muscle strength increased from MMT grade 3 to 4. WOMAC score improved from 67 to 39, indicating functional improvement from severe to moderate disability. No adverse events were reported.

Conclusion: The combination of NMES and stationary cycling was associated with reduced pain and improved joint mobility, muscle strength, and functional ability in an elderly patient following TKR.