Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial

Abstract

Objective: To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients. Design: Phase-II, randomized, parallel-group, allocation-concealed, assessor-blinded, single-center controlled trial. Setting: Inpatient rehabilitation sector. Subjects: Patients following living donor liver transplantation. Interventions: The quadriceps muscle stimulation and the control groups received bilateral muscle electrical stimulation on the quadriceps and tibialis anterior muscles, respectively. Neuromuscular electrical stimulation sessions in both groups were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist. Main measures: Quadriceps muscle strength and quadriceps muscle thickness. Results: Neuromuscular electrical stimulation was applied to the quadriceps muscles group (n = 23) or the tibialis anterior muscle in the control group (n = 22). The decrease in quadriceps muscle thickness differed significantly between both groups on postoperative day 30 (median −3 vs −8, P < 0.01). The changes in predicted quadriceps strength and 6 minutes walking distance were not significantly different between groups (quadriceps strength median −12% vs −5%, P = 0.40; 6 minutes walking distance median −18 vs −21 m, P = 0.74). Conclusion: Neuromuscular electrical stimulation of the quadriceps muscle for liver transplantation recipients was able to maintain the quadriceps muscle thickness after surgery. Future larger scale studies are needed to consider the effectiveness of neuromuscular electrical stimulation and how to incorporate this intervention in the overall strategy of the physical therapy program.