Evoked Electromyographically Controlled Electrical Stimulation

Hayashibe, Mitsuhiro

doi:10.3389/fnins.2016.00335

Cited by 12 publications

(4 citation statements)

References 49 publications

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“…In our study, we assessed real-time muscle endurance in the ICU setting utilizing electromyography ( 56 ). This test is optimal for assessment of muscle endurance and weakness as it offers a way to study the myoelectric features of neuromuscular activation associated with E-Stim ( 57 ). That said, the present study showed the IG had a higher improvement in GNM e with medium effect size at 3 days ( p = 0.06, d = 0.69, Figure 4B ) than the CG, yet a significant improvement with a large effect size at 9 days ( p = 0.04, d = 0.97, Figure 4C ) by increasing 6.3% ( p = 0.029) from baseline ( Table 2 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of electrical stimulation for lower-extremity muscle weakness in intensive care unit 2019 Novel Coronavirus patients: A phase I double-blinded randomized controlled trial

et al. 2022

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BackgroundIntensive care unit (ICU) prolonged immobilization may lead to lower-extremity muscle deconditioning among critically ill patients, particularly more accentuated in those with 2019 Novel Coronavirus (COVID-19) infection. Electrical stimulation (E-Stim) is known to improve musculoskeletal outcomes. This phase I double-blinded randomized controlled trial examined the safety and efficacy of lower-extremity E-Stim to prevent muscle deconditioning.MethodsCritically ill COVID-19 patients admitted to the ICU were randomly assigned to control (CG) or intervention (IG) groups. Both groups received daily E-Stim (1 h) for up to 14 days on both gastrocnemius muscles (GNMs). The device was functional in the IG and non-functional in the CG. Primary outcomes included ankle strength (Ankles) measured by an ankle-dynamometer, and GNM endurance (GNMe) in response to E-Stim assessed with surface electromyography (sEMG). Outcomes were measured at baseline, 3 and 9 days.ResultsThirty-two (IG = 16, CG = 16) lower extremities in 16 patients were independently assessed. The mean time between ICU admission and E-Stim therapy delivery was 1.8 ± 1.9 days (p = 0.29). At 3 days, the IG showed an improvement compared to the CG with medium effect sizes for Ankles (p = 0.06, Cohen’s d = 0.77) and GNMe (p = 0.06, d = 0.69). At 9 days, the IG GNMe was significantly higher than the CG (p = 0.04, d = 0.97) with a 6.3% improvement from baseline (p = 0.029). E-Stim did not alter vital signs (i.e., heart/respiratory rate, blood saturation of oxygen), showed no adverse events (i.e., pain, skin damage, discomfort), nor interfere with ICU standard of care procedures (i.e., mechanical ventilation, prone rotation).ConclusionThis study supports the safety and efficacy of early E-Stim therapy to potentially prevent deterioration of lower-extremity muscle conditions in critically ill COVID-19 patients recently admitted to the ICU. If confirmed in a larger sample, E-Stim may be used as a practical adjunctive therapy.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT04685213].

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of electrical stimulation for lower-extremity muscle weakness in intensive care unit 2019 Novel Coronavirus patients: A phase I double-blinded randomized controlled trial

et al. 2022

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“…That is to say, the EMG signals from the unaffected forearm were used as reference to evaluate the mirror symmetric muscle in the affected side forearm. Thus, different from the closed-loop FES studied in [28], [38], [39], which concentrated on the FES control strategies based on the FES-induced EMG rather than sensing the patients' neuromuscular pathological state, the FES in this study was driven by the EMG bias, so that it could not only avoid the unnecessary stimulation on the unaffected nerves and muscles to reduce the sufferings of users but also alleviate muscle fatigue compared to the cycling fixed intensity FES used in clinical. Furthermore, the designed system had advantages of wireless communication, multiple channels, portable size and real-time capability.…”

Section: Discussionmentioning

confidence: 89%

sEMG Bias-Driven Functional Electrical Stimulation System for Upper-Limb Stroke Rehabilitation

et al. 2018

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It is evident that the dominant therapy of functional electrical stimulation (FES) for stroke rehabilitation suffers from heavy dependency on therapists experience and lack of feedback from patients status, which decrease the patients' voluntary participation, reducing the rehabilitation efficacy. This paper proposes a closed loop FES system using surface electromyography (sEMG) bias feedback from bilateral arms for enhancing upper-limb stroke rehabilitation. This wireless portable system consists of sEMG data acquisition and FES modules, the former is used to measure and analyze the subject's bilateral arm motion intention and neuromuscular states in terms of their sEMG, the latter of multi-channel FES output is controlled via the sEMG bias of the bilateral arms. The system has been evaluated with experiments proving that the system can achieve 39.9 dB signal-to-noise ratio (SNR) in the lab environment, outperforming existing similar systems. The results also show that voluntary and active participation can be effectively employed to achieve different FES intensity for FES-assisted hand motions, demonstrating the potential for active stroke rehabilitation.

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“…It is highly recommended to report the net EMS treatment time for better comparability between clinical studies. To individually optimize stimulation parameters and to compensate response variability and fatigue, evoked electromyographically controlled electrical stimulation can be used for monitoring and adjustment of treatment ( Hayashibe, 2016 ). Investigation of EMS-induced changes on the skeletal muscle should preferably be performed using ultrasound examinations at baseline and follow-up.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill Patients—A Systematic Review

et al. 2022

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Ample evidence exists that intensive care unit (ICU) treatment and invasive ventilation induce a transient or permanent decline in muscle mass and function. The functional deficit is often called ICU-acquired weakness with critical illness polyneuropathy (CIP) and/or myopathy (CIM) being the major underlying causes. Histopathological studies in ICU patients indicate loss of myosin filaments, muscle fiber necrosis, atrophy of both muscle fiber types as well as axonal degeneration. Besides medical prevention of risk factors such as sepsis, hyperglycemia and pneumonia, treatment is limited to early passive and active mobilization and one third of CIP/CIM patients discharged from ICU never regain their pre-hospitalization constitution. Electromyostimulation [EMS, also termed neuromuscular electrical stimulation (NMES)] is known to improve strength and function of healthy and already atrophied muscle, and may increase muscle blood flow and induce angiogenesis as well as beneficial systemic vascular adaptations. This systematic review aimed to investigate evidence from randomized controlled trails (RCTs) on the efficacy of EMS to improve the condition of critically ill patients treated on ICU. A systematic search of the literature was conducted using PubMed (Medline), CENTRAL (including Embase and CINAHL), and Google Scholar. Out of 1,917 identified records, 26 articles (1,312 patients) fulfilled the eligibility criteria of investigating at least one functional measure including muscle function, functional independence, or weaning outcomes using a RCT design in critically ill ICU patients. A qualitative approach was used, and results were structured by 1) stimulated muscles/muscle area (quadriceps muscle only; two to four leg muscle groups; legs and arms; chest and abdomen) and 2) treatment duration (≤10 days, >10 days). Stimulation parameters (impulse frequency, pulse width, intensity, duty cycle) were also collected and the net EMS treatment time was calculated. A high grade of heterogeneity between studies was detected with major cofactors being the analyzed patient group and selected outcome variable. The overall efficacy of EMS was inconclusive and neither treatment duration, stimulation site or net EMS treatment time had clear effects on study outcomes. Based on our findings, we provide practical recommendations and suggestions for future studies investigating the therapeutic efficacy of EMS in critically ill patients.Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021262287].

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Evoked Electromyographically Controlled Electrical Stimulation

Cited by 12 publications

References 49 publications

Safety and efficacy of electrical stimulation for lower-extremity muscle weakness in intensive care unit 2019 Novel Coronavirus patients: A phase I double-blinded randomized controlled trial

Safety and efficacy of electrical stimulation for lower-extremity muscle weakness in intensive care unit 2019 Novel Coronavirus patients: A phase I double-blinded randomized controlled trial

sEMG Bias-Driven Functional Electrical Stimulation System for Upper-Limb Stroke Rehabilitation

Therapeutic Potential of Electromyostimulation (EMS) in Critically Ill Patients—A Systematic Review

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