Neuromuscular Electrical Stimulation Therapy for Muscular

AtrophyNick Cruickshank

Mary Collins

Experiment Objectives

Study of muscular atrophy in individuals following surgical intervention or chronically disabling disease

The population of interest includes individuals diagnosed with knee osteoarthritis (KOA) who have undergone total knee replacement surgery (TKA)

Neuromuscular Electrical Stimulation (NMES) – experimental therapy used as a preventative measure against muscular atrophy

Treatments – Fixed Effects

1. NMES – subjects treated with neuromuscular electrical stimulation

2. PT – subjects treated with the standard care of physical therapy

3. DT – subjects given drug therapy to increase acetylcholine signaling and stimulate motor function

Experimental Procedure

Muscular atrophy will be quantified based on quadriceps cross-sectional measurements from each treatment group

Muscle tissue sectioned and frozen in Optimal Cutting Media in cooled isopentane

Immunohisotchemistry and computed tomography used to measure quadriceps sections cut from muscle tissue

Measurements taken after five weeks of treatment therapy

Statistical Model

Yij = μ + αi + εij

i = treatments = 1, 2, 3

j = subjects = 1, 2, …, r

αi = Fixed Effects of Muscle Atrophy Prevention Technique (NMES, PT, DT)

εij = Experimental Error with Mean = 0 and Variance = σe

2

Statistical Analyses

Tukey method for all pairwise comparisonsWidest margin of errorAnalysis of effectiveness of each treatment

Specific contrasts: ( * = Main contrasts of interest)NMES vs. PT *NMES vs. DT *NMES vs. PT + DT *PT vs. DTPT vs. NMES + DTDT vs. NMES + PT

Power Analysis

Significance Level, α = 0.05

Power = 0.9

V1 = 2, V2 = 21

τ1 = -1σ, τ2 = +1σ, τ3 = 0

σ2 = 1344.72 *

ϕ = √[(rΣτi2)/tσ2] ϕ = 2.309401077

r = 8, n = 24

* From prior experimental data collected in the lab.

Results

NMES is the treatment of interest, with PT and DT used as comparison variables

NMES is an experimental therapy that would be the most cost-effective treatment

Ideally the experiment proves that NMES is equally effective if not more effective at treating muscular atrophy