Who's Afraid of Electrical Stimulation? Let's Revisit the Application of NMES at the Knee. The Journal of orthopaedic and sports physical therapy : Restoring quadriceps strength is essential for successful rehabilitation of knee injuries, but many athletes return to their previous activity with persisting muscle weakness. Strong evidence supports using neuromuscular electrical stimulation (NMES) to improve quadriceps strength; however, there is a lack of widespread clinical implementation. We believe there is a critical need to provide clinical approaches that promote using NMES to improve patients' quadriceps strength and ensuring clinicians provide high-value rehabilitation care. : What is best practice when using NMES to facilitate strength after injury, what are barriers to its use, and how can they be addressed? : We discuss the low clinical implementation of NMES, perceived barriers to using NMES, and provide recommendations for setup and dosage parameters for effective use of NMES. : We aim for this commentary, with accompanying videos, to serve as a resource for clinicians who are using commercially available NMES units in clinical practice. . 10.2519/jospt.2023.12028

Rehabilitation exercise-driven symbiotic electrical stimulation system accelerating bone regeneration. Science advances Electrical stimulation can effectively accelerate bone healing. However, the substantial size and weight of electrical stimulation devices result in reduced patient benefits and compliance. It remains a challenge to establish a flexible and lightweight implantable microelectronic stimulator for bone regeneration. Here, we use self-powered technology to develop an electric pulse stimulator without circuits and batteries, which removes the problems of weight, volume, and necessary rigid packaging. The fully implantable bone defect electrical stimulation (BD-ES) system combines a hybrid tribo/piezoelectric nanogenerator to provide biphasic electric pulses in response to rehabilitation exercise with a conductive bioactive hydrogel. BD-ES can enhance multiple osteogenesis-related biological processes, including calcium ion import and osteogenic differentiation. In a rat model of critical-sized femoral defects, the bone defect was reversed by electrical stimulation therapy with BD-ES and subsequent bone mineralization, and the femur completely healed within 6 weeks. This work is expected to advance the development of symbiotic electrical stimulation therapy devices without batteries and circuits. 10.1126/sciadv.adi6799