Prevention of muscle atrophy in ICU patients without nerve injury by neuromuscular electrical stimulation: a randomized controlled study

Bao, Weiwei; Yang, Jiajia; Li, Mingna; Chen, Kang; Ma, Zheng; Bai, Yuehong; Xu, Yiming

doi:10.1186/s12891-022-05739-2

Cited by 12 publications

(16 citation statements)

References 47 publications

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“…This updated search strategy identified 225 records. After screening, eight studies (12–15, 17–19, 37) were added to the previous 10 RCTs (24–28, 38–42). Although two RCTs appeared to meet the inclusion criteria (43, 44), they were excluded because they used in-bed leg cycling and whole-body vibration in addition to NMES, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The primary outcomes included: 1) ICU-AW at ICU discharge and 2) other adverse events, both defined as per the original authors’ definitions (12–15, 17–19, 24–28). The secondary outcomes were as follows: 1) muscle mass change during ICU stay (29) and 2) muscle strength at ICU discharge as assessed using the Medical Research Council (MRC) score with reliable interobserver agreement (30).…”

Section: Methodsmentioning

confidence: 99%

“…Likewise, recent two meta-analyses have reported that NMES did not decrease the length of ICU stay and mortality of patients with critical illness (10,11). However, after 2019, several randomized controlled trials (RCTs) have reported evidence in support of the use of NMES in the ICU (12)(13)(14)(15)(16)(17)(18)(19). As a result, a meta-analysis to determine the effect of NMES on critically ill patients is urgently required.…”

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confidence: 99%

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Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nakanishi

Yoshihiro

Kawamura³

et al. 2023

Critical Care Medicine

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OBJECTIVES: Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis. DATA SOURCES: We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases from April 2019 to November 2022 to identify new randomized controlled trials to the previous meta-analysis. STUDY SELECTION: We systematically searched the literature for all randomized controlled trials on the effect of NMES in patients with critical illness. DATA EXTRACTION: Two authors independently selected the studies and extracted data. They calculated the pooled effect estimates associated with the occurrence of ICU-AW and adverse events as primary outcomes and muscle mass change, muscle strength, length of ICU stay, mortality, and quality of life as secondary outcomes. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. DATA SYNTHESIS: Overall, eight studies were added to the previous 10 studies. Evidence suggests that the use of NMES reduces the occurrence of ICU-AW (six trials; risk ratio [RR], 0.48; 95% CI, 0.32–0.72); however, NMES may have little to no effect on pricking sensation in patients (eight trials; RR, 6.87; 95% CI, 0.84–56.50). NMES is likely to reduce the change in muscle mass (four trials; mean difference, –10.01; 95% CI, –15.54 to –4.48) and may increase muscle strength (six trials; standardized mean difference, 0.43; 95% CI, 0.19–0.68). Further, NMES may result in little to no difference in the length of ICU stay, and the evidence is uncertain about the effect on mortality and quality of life. CONCLUSIONS: This updated meta-analysis revealed that the use of NMES may result in a lower occurrence of ICU-AW in patients with critical illness, but its use may have little to no effect on pricking sensation in patients.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nakanishi

Yoshihiro

Kawamura³

et al. 2023

Critical Care Medicine

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“…Based on this connection, the research shows that bioelectrical signalling is vital to the healing process(36). In the foot and ankle area, this healing process has been discussed in three primary sections: Regeneration and mending of wound(8), treatment of a damaged nervous system (14), and modi cation of arteriopathies through changes in the cellular proliferation or expression and pattern of genes (19).…”

Section: Summary Of Evidencementioning

confidence: 99%

How might the consideration of cell polarity affect the daily therapeutic practise? A review study.

Ravanbod

2023

Preprint

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Background: In addition to biochemical gradients and transcriptional networks, the behaviour of cells is controlled by endogenous bioelectrical signals resulting from the action of ion channels and pumps. Both biochemical and transcription network modifications can have their impacts through bioelectric modifications, and bioelectric modifications by producing polarity can act as precursor patterns for future genetic evolutions and biochemical modifications. In further details, the proliferation, differentiation, cell shape, and death of stem, progenitor, and somatic cells are governed by instructive messages mediated by variations in resting potential. Cells are regulated not only by their own Vmem (membrane resting potential) but also by the Vmem of their neighbours, establishing networks through electrical synapses known as gap junctions. Changes in the spatial and temporal distribution of Vmem in nonneuronal somatic tissues produce cell polarity which govern pattern development and act as signals that establish the polarity of the body's anatomical axis, and initiate limb regeneration. This article discusses how variations in cell polarity can induce clinical problems and how examining cell polarity might aid in symptom management. Methods: Using Ovid-MEDLINE, Cochrane central, PubMed, Scopus, Web of Science (WOS), and Embase, a comprehensive qualitative literature review was conducted from February 1, 2018, through February 1, 2023. This evaluation includes all types and designs of studies involving the phrases bioelectric, cell polarity, electroceuticals, human, people, diseases, illnesses, and foot and ankle problems, which were connected using the conjunctions "and" and "or." Results: From a total of 1281 publications identified, 27 were chosen. One of this research investigated bioelectric wound healing. 25 studies addressed bioelectric nerve cell growth, whereas one evaluated bioelectricity-induced cellular differentiation in the treatment of arteriopathies. Conclusion: After analysing the data, the author recommends that cell polarity be addressed for the treatment and prevention of most, if not all, foot and ankle problems. This strategy will assist in addressing most of the predisposing factors and healing impediments for a disease, hence enhance healing process and reducing the likelihood of recurrence or parallel conditions. Due to the limits of bioelectricity measurement and the involvement of mechanical and chemical gradients, more studies are required to confirm these results.

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“…Consequently, it remains unclear how NMES should be applied to achieve the best results in enhancing QF strength and function (15). Some studies have shown that NMES is superior to voluntary exercise in preventing muscle loss following a period of immobilization (14)(15)(16)(17). Limited evidence exists to support the effectiveness of NMES in restoring muscle mass in patients with KOA compared to conventional exercise therapy.…”

Section: Introductionmentioning

confidence: 99%

A Controlled Randomized Trial with a 12-Week Follow-up Investigating the Effects of Medium-frequency Neuromuscular Electrical Stimulation on Pain, VMO Thickness, and Functionality in Patients with Knee Osteoarthritis.

Moezy,

Masoudi,

Nazari

et al. 2023

Preprint

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Background: One of the major contributors to disability in Knee osteoarthritis (KOA) patients is weakness in the Quadriceps Femoris muscle. Neuromuscular electrical stimulation (NMES) has been used in rehabilitation for patients suffering from muscle weakness. Thus, the purpose of the study was to assess the effectiveness of NMES and exercise therapy, for improving pain, muscle weakness and function among patients with KOA. Methods: A randomized controlled trial was conducted with 75 female patients diagnosed with KOA. Participants were divided into three intervention groups: NMES-only, exercise therapy (Exs) alone, and a combination of NMES and exercise (NMES+ Exs). All patients underwent 12 supervised treatment sessions, three times a week. Outcome measures included pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), thigh muscle girth (TG), thickness of the Vastus Medialis Oblique (VMO), timed up and go test (TUG), six-minute walk test (6MWT), and WOMAC scores. Statistical analyses (ANOVA and Kruskal-Wallis) methods were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks. Results: The NMES group exhibited a significant reduction in pain at the 12-week follow-up compared to the other groups(p=0.022). The NMES+ Exs group showed better outcomes in terms of FROM, TG, and VMO thickness post-intervention (p <0.0001, p<0.004, p=0.003, respectively) and at the 12-week follow-up (p <0.0001, p <0.0001, p <0.0001, respectively). Additionally, NMES was superior in improving TUG and 6MWT post-intervention (p <0.0001, p=0.038, respectively) and during the follow-up assessments (p <0.0001, p=0.029, respectively). The NMES+ Exs group achieved better WOMAC stiffness scores at both post-intervention and follow-up evaluations (p <0.0001, p <0.0001, respectively). Furthermore, at the 12-week follow-up, NMES+ Exs group outperformed the others in WOMAC pain and function subscales (p=0.003, p=0.017, respectively), while the NMES group demonstrated better WOMAC total scores compared to the other groups (p=0.007). Conclusion: The combination of NMES and exercise seems to be an efficient approach for managing KOA, as it enhances knee flexion range and TG, increases VMO thickness, and improves WOMAC scores. On the other hand, NMES alone was found to be effective in improving the physical function of KOA patients. Trial registration: IRCT20101228005486N7 (06-02-2020).

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Prevention of muscle atrophy in ICU patients without nerve injury by neuromuscular electrical stimulation: a randomized controlled study

Cited by 12 publications

References 47 publications

Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

How might the consideration of cell polarity affect the daily therapeutic practise? A review study.

A Controlled Randomized Trial with a 12-Week Follow-up Investigating the Effects of Medium-frequency Neuromuscular Electrical Stimulation on Pain, VMO Thickness, and Functionality in Patients with Knee Osteoarthritis.

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