Electrical Muscle Stimulation: An Effective Form of Exercise and Early Mobilization to Preserve Muscle Strength in Critically Ill Patients

Eleftherios Karatzanos,Dimitra Tsimpouki,Serafim Nanas,Christina Routsi,Ioannis Vasileiadis,Georgios Mitsiou,Vasiliki Gerovasili,Elli-Sophia Tripodaki,Emmanouil Papadopoulos,Kleovoulos Apostolou,Dimitrios Zervakis

doi:10.1155/2012/432752

Abstract

Purpose. This is a secondary analysis of previously published data to investigate the effects of electrical muscle stimulation (EMS) on strength of various muscle groups in critically ill patients. Methods. One hundred forty-two consecutive patients, with APACHE II score ≥ 13, were randomly assigned to the EMS or the control group. EMS sessions were applied daily on vastus lateralis, vastus medialis, and peroneus longus of both lower extremities. Various muscle groups were evaluated with the Medical Research Council (MRC) scale for muscle strength. Handgrip strength assessment was also employed. Results. Twenty four patients in the EMS group and 28 patients in the control group were finally evaluated. EMS patients achieved higher MRC scores than controls (P ≤ 0.05) in wrist flexion, hip flexion, knee extension, and ankle dorsiflexion. Collectively, the EMS group performed higher (P < 0.01) in the legs and overall. Handgrip strength correlated (P ≤ 0.01) with the upper and lower extremities' muscle strength and the overall MRC scores. Conclusions. EMS has beneficial effects on the strength of critically ill patients mainly affecting muscle groups stimulated, while it may also affect muscle groups not involved presenting itself as a potential effective means of muscle strength preservation and early mobilization in this patient population.

Highlights

Intensive Care Unit acquired weakness (ICU-AW) is a neuromuscular complication frequently observed in survivors of acute critical illness
We have found that electrical muscle stimulation (EMS) prevents ICU-AW, which was diagnosed in 12.5% of the EMS group in comparison to 39.3% of the control group and results
No significant between-group differences were observed for the Medical Research Council (MRC) score of the left and the right arm either, while the MRC scores of the left and right legs were significantly higher in the EMS group

Summary

Introduction

Intensive Care Unit acquired weakness (ICU-AW) is a neuromuscular complication frequently observed in survivors of acute critical illness. It is characterized by profound muscle weakness [1] and is associated with delayed weaning from mechanical ventilation [2]. Apart from controlling for potentially reversible risk factors and subsequent adjustment of therapy, no other effective means have been suggested so far for the prevention of ICU-AW. Prevention of ICU-AW is related to early mobilization and rehabilitation in the ICU. Recent studies have demonstrated that early mobilization can be safe and feasible, with a potential reduction in short-term physical impairment [7, 8]. Patient’s cooperation is necessary for an essential intervention to be applied

Methods

Results

Conclusion