Electrical Muscle Stimulation Group Research Articles

Effect of At-home Beauty Device Equipped with Microcurrent and Electrical Muscle Sitmulation Functions on the Elasticity and Lifting of Facial Skin

At-home beauty devices used in facial skin are developed by combining various technologies such as electromagnetic waves, microcurrents, and lasers according to the main purpose of consumers. This study aimed to assess the effects of increasing of facial elasticity, improvement of eye wrinkles, and facial lifting in healthy Korean women to objectively prove the efficacy of an at-home beauty device equipped with microcurrent (MC) and medium-frequency electrical muscle stimulation (EMS). A total of 44 participants used the at-home beauty device and cosmetics together on the left side of the face (test area), and applied only cosmetics to the right side (control area). The results of the assessment, the improvement in the dermal density and eye wrinkles was clearly observed in the MC mode use group. In the EMS mode use group, the lifting effect of the cheek and decreasing facial swelling were clearly observed, and the lifting effect of the sagging double chin was also confirmed. Especially, EMS group had derived reproducible results like previous studies, and the skin improvement effects were proved again. MC and EMS, which are mainly used for therapeutic purposes, were developed into at-home beauty device, and this study confirmed that they are effective in facial elasticity, eye wrinkles, and facial lifting. Based on the research, we hope that various research for at-home beauty devices equipped with various functions are actively conducted.

Electrical Stimulation Intensity to Induce Sensory Reweighting Dynamics While Standing on Balance Board.

In human postural control, maladaptation of sensory reweighting to sudden environmental changes is one of the main causes of postural instability. Providing sensory cues for body motion by means of stimulation could induce the sensory reweighting dynamics. In this paper, we aimed to investigate the intensity level of electrical stimulation to induce sensory reweighting dynamics while standing on a balance board under three conditions: no stimulation (control), electrotactile stimulation (ETS) at a low-intensity level, and electrical muscle stimulation (EMS) at a high-intensity level. A total of 30 participants (ten for each condition) controlled their posture to keep the board horizontal in a balance-board task, which included a pre-test without stimulation, a stimulation test, and a post-test without stimulation. The EMS and ETS groups received electrical stimulation to the tibialis anterior or soleus muscles based on the board tilt. Before and after the balance-board task, participants performed static standing with their eyes open and also with their eyes closed to evaluate the visual reweighting. In the EMS group, the visual reweighting showed a strong negative correlation with the balance-board sway ratio between the pre- and stimulation tests, indicating that EMS induced a tendency that requires visual up-weighting to improve postural balance. However, there were no significant correlations between either parameter in the control and ETS groups. These results suggest that high-intensity electrical stimulation at the level of directly contracting muscles may be effective in reliably inducing sensory reweighting dynamics, while low-intensity electrical stimulation may be insufficient.Clinical relevance- These findings will be helpful for designing stimulus conditions to reliably induce the reweighting during balance training, and for establishing a new balance training method utilizing EMS to induce visual up-weighting.

Induced effects of electrical muscle stimulation and visual stimulation on visual sensory reweighting dynamics during standing on a balance board.

Providing instruction cues on body motions using stimulations has the potential to induce sensory reweighting dynamics. However, there are currently very few quantitative investigations on the difference in the induced effects on the sensory reweighting dynamics between stimulation methods. We therefore investigated the difference in the induced effects of electrical muscle stimulation (EMS) and visual sensory augmentation (visual SA) on sensory reweighting dynamics during standing on a balance board. Twenty healthy participants controlled their posture to maintain the board horizontally in the balance-board task, which included a pre-test without stimulation, a stimulation test, and a post-test without stimulation. The EMS group (n = 10) received EMS to the tibialis anterior or soleus muscle based on the board tilt. The visual SA group (n = 10) received visual stimuli via a front monitor based on the board tilt. We measured the height of the board marker and calculated the board sway. Before and after the balance-board task, the participants performed static standing with their eyes open and closed. We measured postural sway and calculated the visual reweighting. The visual reweighting showed a strong negative correlation with the balance board sway ratio between the pre- and stimulation tests in the EMS group and a strong positive correlation with that in the visual SA group. Moreover, for those who reduced the balance board sway in the stimulation test, the visual reweighting was significantly different between the stimulation methods, demonstrating that the induced effect on sensory reweighting dynamics is quantitatively different depending on which method is used. Our findings suggest that there is an appropriate stimulation method to change to the targeted sensory weights. Future investigations on the relationship between sensory reweighting dynamics and stimulation methods could contribute to the proposal and implementation of new training methods for learning to control the target weights.

The effect of blood flow restriction training combined with electrical muscle stimulation on neuromuscular adaptation: a randomized controlled trial.

Objective: Low-intensity resistance training (≤25% 1RM) combined with blood flow restriction training (BFRT) is beneficial to increasing muscle mass and muscle strength, but it cannot produce increased muscle activation and neuromuscular adaptation, as traditional high-intensity strength training does. The purpose of this study is to investigate the effects of independently applying BFRT and electrical muscle stimulation (EMS), as well as combining the two methods, on muscle function. Methods: Forty healthy participants with irregular exercise experiences were randomly assigned to four groups: BFRT-alone group (BFRT, n = 10), EMS-alone group (EMS, n = 10), BFRT combined with EMS group (CMB, n = 10), and the control group (CTR, n = 10). All participants received low-intensity squat training at a load of 25% 1RM 5 times/week for 6weeks. Cross-sectional area (CSA) and electromyographic root mean square (RMS) in the rectus femoris, as well as peak torque (PT) of the knee extensor, were measured before and following a 6-week intervention. Results: Following the 6-week intervention, the increases in muscle activation in the CMB group were statistically higher than those in the BFRT group (p < 0.001), but not different from those in the EMS group (p = 0.986). Conclusion: These data suggest that the combination of BFRT and EMS for low-intensity squat training improved the muscle strength of the lower limbs by promoting muscle hypertrophy and improving muscle activation, likely because such a combination compensates for the limitations and deficiencies of the two intervention methods when applied alone.

Effects of Intermittent Hypoxia and Electrical Muscle Stimulation on Cognitive and Physiological Metrics.

This study describes the effects of interval hypoxic training and electrical muscle stimulation (EMS) technology on human productivity with the following metrics: biochemical indices, cognitive abilities, changes in oxygenated (HbO) and deoxygenated (Hb) hemoglobin concentrations over the prefrontal cortex, and functional connectivity via electroencephalography (EEG). All measurements according to the described technology were made before the start of training and one month later, right after it ended. The study involved middle-aged Indo-European men. Specifically, there were 14, 15, and 18 participants in the control, hypoxic, and EMS groups, respectively. EMS training improved reactions and nonverbal memory but decreased attention scores. Functional connectivity decreased in the EMS group while it increased in the hypoxic group. A result of the interval normobaric hypoxic training (IHT) was significantly improved contextual memory, with a p-value = 0.08. It was found that EMS training is more likely to cause stress on the body than positively affect cognitive functions. At the same time, interval hypoxic training can be considered a promising direction for increasing human productivity. The data obtained during the study can also help in the timely diagnosis of insufficient or overestimated indicators of biochemistry.

Investigation of the Effects of Electrical Muscle Stimulation (EMS) and Traditional Training on Strength Gain and Anthropometric Properties in Sedentary Women

Bu çalışmanın amacı, Elektriksel Kas Uyarımı (EMS) antrenmanı ile geleneksel fitness antrenmanı uygulamalarının sedanter kadınlar üzerinde antropometrik ve kuvvet değerleri üzerine olan etkilerinin incelenmesidir. Araştırmaya Osmaniye ilinde yaşayan 20 sedanter kadın (yaş 25.40 ± 1.10) gönüllü olarak katılmıştır. Katılımcılar EMS ve fitness antrenman grubu olarak iki gruba ayrılmıştır. Verilerin normallik dağılımına Shapiro-Wilk sınaması ile bakılmıştır. Veriler normal dağılım gösterdiğinden 6 hafta uygulanan antrenmanların ön test ve son test antropometrik ve kuvvet karşılaştırmaları için bağımlı gruplar T testi kullanılmıştır. EMS ve fitness grubunun antropometrik değişkenlere (vücut ağırlığı, vücut kütle indeksi, yağ yüzde değerleri ve yağsız vücut kütlesi) göre ön test-son test değerleri arasında istatiksel olarak anlamlı farklılık görülmemiştir (p&amp;gt;0.05). Çevre ölçümlerinde EMS antrenman grubunun ön test son test değerlerinde istatistiksel olarak anlamlı farklılık bulunmamıştır (p&amp;gt;0.05). Fitness antrenman grubunda biceps ve biceps kasılı çevre ölçümlerinde fark anlamlı bulunurken karın, kalça ve göğüs çevresinde EMS grubunda olduğu gibi anlamlı farklılık bulunmamıştır. Çalışma sonucunda, EMS ve Fitness grubunun kuvvet ön test- son test değerlerinde anlamlı farklar bulunmuştur. Sonuç olarak EMS antrenmanı ve geleneksel fitness antrenmanı sonucu sedanter kadınlarda kuvvet kazanımı sağlanmıştır. Bu bulgudan hareketle sakatlık riskinin daha az olduğu kısa sürede ve kolay uygulanabilen yeni teknoloji EMS antrenmanları geleneksel fitness antrenmanlara ek olarak önerilmektedir.

Efficacy and Safety of Acute Phase Intensive Electrical Muscle Stimulation in Frail Older Patients with Acute Heart Failure: Results from the ACTIVE-EMS Trial.

As frailty in older patients with acute heart failure (AHF) has an adverse effect on clinical outcomes, the addition of electrical muscle stimulation (EMS) to exercise-based early rehabilitation may improve the effects of treatment. Post hoc analysis was performed on a randomized controlled study for clinical outcomes and prespecified subgroups (ACTIVE-EMS: UMIN000019551). In this trial, 31 AHF patients aged ≥ 75 years with frailty (Short Physical Performance Battery [SPPB] score 4–9) were randomized 1:1 to receive treatment with an early rehabilitation program only (n = 16) or early rehabilitation with add-on EMS therapy (n = 15) for 2 weeks. Changes in physical function and cognitive function between baseline and after two weeks of treatment were assessed. There were no adverse events during the EMS period. The EMS group showed significantly greater changes in quadriceps’ isometric strength and SPPB compared to the control group, and EMS therapy showed uniform effects in the prespecified subgroups. There were no significant differences in the changes in other indexes of physical function and cognitive function between groups. There was no significant difference in the rate of heart failure hospitalization at 90 days between groups. In conclusion, older AHF patients with frailty showed greater improvement in lower extremity function with the addition of EMS therapy to early rehabilitation without adverse events.

Effects of Arm-cranking Training with Electrical Muscle Stimulation on Vessel Function.

This study aimed to determine whether arm-cranking training with electrical muscle stimulation (EMS) results in a greater improvement in vessel function than performing the same exercise without EMS. First, nine healthy young men performed two 20-min arm-cranking trials at 50% V˙O2max with and without EMS applied to the lower limbs. The flow-mediated vasodilation (FMD) of the right brachial artery was measured using a high-resolution ultrasound device. Both FMD and normalized FMD were increased significantly after the arm-cranking with EMS trial, and significant differences were observed between the two trials. Second, 16 healthy adult men were randomly assigned to either the arm-cranking exercise training (A) group or arm-cranking training with EMS (A+EMS) group. The subjects were engaged in 20 min of arm-cranking at 50% V˙O2max twice a week for 8 weeks with/without EMS applied to the lower limbs. The FMD increased significantly after A+EMS training session and the FMD in A+EMS group was significantly higher than that in the A group. These results indicate that acute/chronic endurance arm-cranking with EMS applied to the lower limbs improves the brachial artery endothelial function more markedly than the same exercise without EMS.

Blood Flow Restriction Combined with Electrical Stimulation Attenuates Thigh Muscle Disuse Atrophy.

This study aimed to investigate the effects of blood flow restriction (BFR) combined with electrical muscle stimulation (EMS) on skeletal muscle mass and strength during a period of limb disuse. Thirty healthy participants (22 ± 3 yr; 23 ± 3 kg·m-2) were randomly assigned to control (CON; n = 10), BFR alone (BFR; n = 10), or BFR combined with EMS (BFR + EMS; n = 10). All participants completed unloading of a single leg for 14 d, with no treatment (CON), or while treated with either BFR or BFR + EMS (twice daily, 5 d·wk-1). BFR treatment involved arterial three cycles of 5-min occlusion using suprasystolic pressure, each separated by 5 min of reperfusion. EMS (6 s on, 15 s off; 200 μs; 60 Hz; 15% maximal voluntary contraction [MVC]) was applied continuously throughout the three BFR cycles. Quadriceps muscle mass (whole-thigh lean mass via dual-energy x-ray absorptiometry and vastus lateralis [VL] muscle thickness via ultrasound) and strength (via knee extension MVC) were assessed before and after the 14-d unloading period. After limb unloading, whole-thigh lean mass decreased in the control group (-4% ± 1%, P < 0.001) and BFR group (-3% ± 2%, P = 0.001), but not in the BFR + EMS group (-0.3% ± 3%, P = 0.8). VL muscle thickness decreased in the control group (-4% ± 4%, P = 0.005) and was trending toward a decrease in the BFR group (-8% ± 11%, P = 0.07) and increase in the BFR + EMS group (+5% ± 10%, P = 0.07). Knee extension MVC decreased over time (P < 0.005) in the control group (-18% ± 15%), BFR group (-10% ± 13%), and BFR + EMS group (-18% ± 15%), with no difference between groups (P > 0.5). Unlike BFR performed in isolation, BFR + EMS represents an effective interventional strategy to attenuate the loss of muscle mass during limb disuse, but it does not demonstrate preservation of strength.

Effect of Electrical Muscle Stimulation on Upper and Lower Limb Muscles in Critically Ill Patients: A Two-Center Randomized Controlled Trial.

Electrical muscle stimulation is widely used to enhance lower limb mobilization. Although upper limb muscle atrophy is common in critically ill patients, electrical muscle stimulation application for the upper limbs has been rarely reported. The purpose of this study was to investigate whether electrical muscle stimulation prevents upper and lower limb muscle atrophy and improves physical function. Randomized controlled trial. Two-center, mixed medical/surgical ICU. Adult patients who were expected to be mechanically ventilated for greater than 48 hours and stay in the ICU for greater than 5 days. Forty-two patients were randomly assigned to the electrical muscle stimulation (n = 17) or control group (n = 19). Primary outcomes were change in muscle thickness and cross-sectional area of the biceps brachii and rectus femoris from day 1 to 5. Secondary outcomes included occurrence of ICU-acquired weakness, ICU mobility scale, length of hospitalization, and amino acid levels. The change in biceps brachii muscle thickness was -1.9% versus -11.2% in the electrical muscle stimulation and control (p = 0.007) groups, and the change in cross-sectional area was -2.7% versus -10.0% (p = 0.03). The change in rectus femoris muscle thickness was -0.9% versus -14.7% (p = 0.003) and cross-sectional area was -1.7% versus -10.4% (p = 0.04). No significant difference was found in ICU-acquired weakness (13% vs 40%; p = 0.20) and ICU mobility scale (3 vs 2; p = 0.42) between the groups. The length of hospitalization was shorter in the electrical muscle stimulation group (23 d [19-34 d] vs 40 d [26-64 d]) (p = 0.04). On day 3, the change in the branched-chain amino acid level was lower in the electrical muscle stimulation group (40.5% vs 71.5%; p = 0.04). In critically ill patients, electrical muscle stimulation prevented upper and lower limb muscle atrophy and attenuated proteolysis and decreased the length of hospitalization.

The possibility of using skeletal muscle electrical stimulation in the rehabilitation of patients after cardiac surgery

Aim. To evaluate the effectiveness of electrical muscle stimulation (EMS) in patients with the complicated early postoperative period after cardiac surgery.Methods. 61 patients (44 men and 17 women) aged 52-70 years with the complicated early postoperative period after cardiac surgery were included in the study. The complications included prolonged length of stay in the intensive care unit and prolonged mechanical ventilation. The initial muscle performance of the lower extremities was measured with the carpal and isokinetic dynamometer in all patients. The six-minute walk test was performed in all patients after they had been transferred to the department of cardiac surgery.Results. Patients in the study group had reduced lower extremity muscle strength at baseline, compared with the control group. After the EMS sessions, the study group patients demonstrated pronounced improvements in muscle performance as compared to the control group. Both knee-joint extension values increased during the isometric contraction as compared to those in the control group (38.8% and 40.0% versus 8.1% and 8.4%, p &lt;0.001), similarly to right knee-joint flexion (23.7% versus 10.1%, p = 0.008), left ankle joint (18.6 versus 4.3%, p = 0.010), right-hand grip strength (18.3 versus 11.1%, p = 0.042). In addition, the six-minute walk test results improved in the EMS group (119.72% (293 meters) and 87.13% (315 meters)) as compared to the control group (p = 0.079).Conclusion. The EMS sessions did not affect the clinical status of cardiac surgical patients with the complicated postoperative period. Moreover, it appeared to be beneficial in terms of the improved lower extremity muscle strength that was more pronounced in the study group than in the control group. Therefore, the effects of EMS on the clinical status of these patients require the further investigation.

Effects of Electrical Muscle Stimulation in Subjects Undergoing Prolonged Mechanical Ventilation.

Muscle atrophy and deconditioning are common complications in patients on prolonged mechanical ventilation (PMV). There are few studies that reviewed the effects of electrical muscle stimulation in this population. The purpose of this study was to examine the effects of electrical muscle stimulation on muscle function and hospitalization outcomes in subjects with PMV. Subjects on mechanical ventilation for ≥21 d were randomly assigned to the electrical muscle stimulation group (n = 16) or the control group (n = 17). The electrical muscle stimulation group received daily muscle electrical stimulation for 30 min/session for 10 d. The measurement of muscle strength (by medical research council [MRC] scale), leg circumference, and physical functional status (by Functional Independence Measure [FIM] scores) were performed before and after completion of the study. The length of stay in respiratory care center of subjects were recorded. After electrical muscle stimulation, there was no difference in pulmonary function between the electrical muscle stimulation and control groups. Significantly increased in MRC points was found in the electrical muscle stimulation group after intervention (2 [1-7] points vs 2 [1-3.5] points, respectively, P = .034). No difference in MRC points was found between baseline and post-measurement in the control group (1[1-2] points vs 1[1-2.5] points, respectively, P > .99). At the end of the study, leg circumference in control group significantly decreased when compared with baseline (47.5 ± 8.3 cm vs 44.6 ± 5.7 cm, respectively, P = .004) and remained unchanged in the EMS group. However, no significant differences were found between the electrical muscle stimulation and control groups. There was no difference in physical functional status and hospital stay between the electrical muscle stimulation and control groups. Electrical muscle stimulation enhanced muscle strength in subjects who received PMV. Electrical muscle stimulation can be considered a preventive strategy for muscle weakness in patients who receive PMV. (ClinicalTrials.gov registration NCT02227810.).

Efficacy of belt electrode skeletal muscle electrical stimulation on reducing the rate of muscle volume loss in critically ill patients: A randomized controlled trial.

Belt electrode skeletal muscle electrical stimulation can induce muscle contraction of the whole lower body. This study examined the efficacy of belt electrode skeletal muscle electrical stimulation on reducing loss of muscle volume in critically ill patients. Intensive care unit patients were randomly assigned to control and electrical muscle stimulation groups. In both groups, early rehabilitation was administered from day 2 of admission. In the electrical muscle stimulation group, belt electrode skeletal muscle electrical stimulation was administered. Femoral muscle volume was evaluated with computed tomography on days 1 and 10. Ninety-Four severely ill patients were included 47 patients were assigned to each group. Femoral muscle volumes of 16 control and 21 electrical muscle stimulation group patients were measured. For both groups, femoral muscle volume decreased significantly from day 1 to day 10 (p < 0.0001). The mean rate of muscle volume loss was 17.7% (standard deviation (SD) 10.8%) for the control group and 10.4% (SD 10.1%) for the electrical muscle stimulation group (p = 0.04). The score for stair-climbing of Barthel Index was significantly better in the electrical muscle stimulation group 3.9 (SD 4.0) than in the control group 1.5 (1.5) (p = 0.04). Belt electrode skeletal muscle electrical stimulation has the potential to inhibit muscle volume loss in critical care.

Electrical Stimulation to the Infraspinatus on Hypertrophy and Strength of the Shoulder.

The purpose of this study was to determine the effects of six weeks of electrical muscle stimulation (EMS) on the strength and muscle mass of the infraspinatus muscle. Twenty non-athletes (age: 24±3.4 years, height: 171.5±5.6 cm, mass: 65.2±8.1 kg) were randomly classified into two groups, an electrical muscle stimulation group (EMS group) and a control group (CON group). The EMS group completed a total of 18 20- min EMS sessions, three times per week over a period of six weeks, while the CON group received no intervention. The muscle thicknesses of both the infraspinatus and the deltoid muscles, the cross-sectional area (CSA) of the whole infraspinatus muscle, and the isometric and isokinetic peak torques of shoulder external rotations were measured before and after intervention. It was found that the muscle thickness of the superior infraspinatus (Pre 0.92±0.19 cm2, Post 0.99±0.16 cm2, p=0.02) and the CSA (Pre 10.99±1.32 cm2, Post 11.99±1.02 cm2, p=0.03) significantly increased in the EMS group. This study demonstrated that EMS of the infraspinatus muscle over a period of six weeks resulted in hypertrophy of the infraspinatus muscle.

Beneficial Effect of Intradialytic Electrical Muscle Stimulation in Hemodialysis Patients: A Randomized Controlled Trial.

Many hemodialysis (HD) patients cannot perform self-administered exercise training for their muscle wasting, weakness, and sarcopenia. Electrical muscle stimulation (EMS) has the advantages of easy application, and minimal risks for these patients. This study aimed to evaluate the effects of intradialytic EMS. This was a prospective, open-label, randomized controlled trial. Twenty-nine HD patients were randomly assigned to either the EMS group or the control (no training) group, and 13 patients in each group were eventually analyzed. The EMS group received intradialytic EMS over an 8-week period. Measurement of isometric knee extensor strength using a handheld dynamometer, evaluation of the quadriceps cross-sectional area (CSA) using magnetic resonance imaging (MRI), the Timed Up & Go Test (TUG) for physical function assessment, the Japanese version of the Short Form-8 Health Survey (SF-8), and blood tests were performed before and after the intervention period. The primary and secondary outcomes were improvement of quadriceps muscle strength and size, respectively. The EMS group demonstrated significant improvement compared with the control group in terms of knee extensor strength (right: 22.3 ± 12.8 vs. -10.8 ± 22.3 N, P < 0.001; left: 26.1 ± 29.7 vs. -8.3 ± 18.7 N, P < 0.001), quadriceps CSA at three positions, 25, 50, and 75% of the segment length from the greater trochanter to the inferior border of the lateral epicondyle of the femur (25% right: EMS group 1.7 ± 2.0 vs. Control group -0.4 ± 1.8cm2 , P = 0.05; 25% left: EMS group 1.3 ± 1.1 vs. Control group -0.6 ± 1.8cm2 , P = 0.01; 50% right: EMS group 2.0 ± 2.2 vs. Control group -0.7 ± 1.9cm2 , P = 0.004; 50% left: EMS group 2.7 ± 2.1 vs. Control group -0.7 ± 1.6cm2 , P = 0.001; 75% right: EMS group 1.8 ± 2.2 vs. Control group -0.7 ± 1.5cm2 , P = 0.003; 75% left: EMS group 2.1 ± 1.9 vs. Control group -0.4 ± 1.5cm2 , P = 0.003); and TUG time (-0.8 ± 0.6 vs. 0.2 ± 0.5s, P < 0.001). The EMS group showed improvement after intervention in all components of SF-8, but these were not statistically significant. EMS could be an effective exercise training tool for HD patients with either muscle wasting, weakness, or sarcopenia.

Effects of Electrical Muscle Stimulation on Waist Circumference in Adults with Abdominal Obesity: A Randomized, Double-blind, Sham-controlled Trial

We investigated the effects of electrical muscle stimulationon waist circumference as compared with an identical device providing transcutaneous electrical nerve stimulation as control in adults with abdominal obesity. This was a randomized, double-blind, sham-controlled trial. Sixty patients with abdominal obesity received electrical muscle stimulation or transcutaneous electrical nerve stimulation randomly five times a week for 12 weeks. The electrical muscle stimulationgroup achieved a mean 5.2±2.8 cm decrease in waist circumference while the transcutaneous electrical nerve stimulation group showed only a 2.9±3.3 cm decrease (P=0.005). About 20 (70.0%) of the electrical muscle stimulation group lost more than 4 cm of waist circumference but that only 8 (33.3%) of the transcutaneous electrical nerve stimulation group did so (P=0.008). Furthermore, fasting free fasting acid levels were significantly higher in the electrical muscle stimulation than in the transcutaneous electrical nerve stimulationgroup at week 12 (P=0.006). In the electrical muscle stimulation group, slight decreases in visceral abdominal fat and total abdominal fat areas by computer tomography were observed at 12 weeks, but these decreases were not significant. In addition, patients' self-rated satisfaction scores with this program were significantly higher in the electrical muscle stimulation group. The 12-week electrical muscle stimulation program modestly reduced waist circumference in abdominally obese adults without side effects.

Hemodynamic effects of electrical muscle stimulation in the prophylaxis of deep vein thrombosis for intensive care unit patients: a randomized trial

BackgroundDeep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT.MethodsThis study included 26 patients admitted to a single ICU. We enrolled patients who could not move themselves due to spinal cord injury, head injury, central nervous system abnormalities, and sedation for mechanical ventilation. The patients were randomly allocated to either the EMS group or the control group. Patients in the EMS group received 30-min sessions of EMS applied to the bilateral lower extremities on arbitrary days within 14 days after admission. The control patients received no EMS. The peak flow velocity and diameter of the popliteal vein (Pop.V) and common femoral vein (CFV) were measured by ultrasound and then the volumes of venous flow were calculated using a formula.ResultsThere were no statistically significant differences in patient characteristics between the two groups except for the mortality rate. In the EMS group, the median and interquartile range (IQR, 25th–75th percentile) of velocities of the Pop.V and CFV were higher during EMS compared with at rest: 10.6 (8.0–14.8) vs 24.5 (15.1–37.8) cm/s and 17.0 (12.3–23.8) vs 24.3 (17.0–33.0) cm/s, respectively (p < 0.05). The median (IQR) of volumes of venous flow of the Pop.V and CFV at rest and during EMS were 4.2 (2.7–7.2) vs 8.6 (5.4–16.1) cm3/s and 12.9 (9.7–21.4) vs 20.8 (12.3–34.1) cm3/s, respectively (p < 0.05). There were no major complications related to EMS.ConclusionsEMS increased the venous flow of the lower limbs. EMS could be one potential method for venous thromboprophylaxis.Trial registrationUMIN000013642

Role of Electrical Muscle Stimulation (EMS) for Treatment or Prevention of ICU-associated Weakness

Background: Neuromuscular abnormalities developing as a consequence of critical illness can be found in the majority of patients hospitalized in the intensive care unit (ICU) for 1 week or more. The spectrum of illness ranges from isolated nerve entrapment with focal pain or weakness, to disuse muscle atrophy with mild weakness, to severe myopathy or neuropathy with associated severe, prolonged weakness. The prevalence and impact of acquired neuromuscular weakness is likely larger than generally recognized. Greater than 50% of patients mechanically ventilated for more than 7 days will develop electrophysiologic abnormalities, with 25–33% developing clinically overt weakness. Acquired neuromuscular dysfunction is associated with difficulty in separating from mechanical ventilation, increased hospital costs, and increased mortality. Objective: This study was designed to investigate the effects of electrical muscle stimulation (EMS) on strength of muscle groups stimulated and gain in functional independence in critically ill patients. Methods: Subjects were recruited among the patient admitted in multidisciplinary intensive care units during the study period. The study employed a randomized single blind controlled experimental study design consisting of two group experimental group (Electrical stimulation group) and control group. The MRC score was used for clinical assessment of muscle strength and barthel index were used to assess the level of independence. Results: EMS group patients achieved higher MRC scores than controls in knee extensors (left P ≤ 0.01), (right P ≤ 0.01) and ankle dorsiflexors (left P ≤ 0.02), (right P ≤ 0.02). Conclusions: EMS has beneficial effects on the preserving strength of critically ill patients mainly affecting muscle groups stimulated, it also has beneficial effect on improving the functional independence level post ICU discharge, it can be considered as a potential effective means of muscle strength preservation and early mobilization in this patient population.

Daily Electrical Muscle Stimulation Enhances Functional Recovery Following Nerve Transection and Repair in Rats

Background. Incomplete recovery following surgical reconstruction of damaged peripheral nerves is common. Electrical muscle stimulation (EMS) to improve functional outcomes has not been effective in previous studies. Objective. To evaluate the efficacy of a new, clinically translatable EMS paradigm over a 3-month period following nerve transection and immediate repair. Methods. Rats were divided into 6 groups based on treatment (EMS or no treatment) and duration (1, 2, or 3 months). A tibial nerve transection injury was immediately repaired with 2 epineurial sutures. The right gastrocnemius muscle in all rats was implanted with intramuscular electrodes. In the EMS group, the muscle was electrically stimulated with 600 contractions per day, 5 days a week. Terminal measurements were made after 1, 2, or 3 months. Rats in the 3-month group were assessed weekly using skilled and overground locomotion tests. Neuromuscular junction reinnervation patterns were also examined. Results. Muscles that received daily EMS had significantly greater numbers of reinnervated motor units with smaller average motor unit sizes. The majority of muscle endplates were reinnervated by a single axon arising from a nerve trunk with significantly fewer numbers of terminal sprouts in the EMS group, the numbers being small. Muscle mass and force were unchanged but EMS improved behavioral outcomes. Conclusions. Our results demonstrated that EMS using a moderate stimulation paradigm immediately following nerve transection and repair enhances electrophysiological and behavioral recovery.

Effect of electrical muscle stimulation on prevention of ICU acquired muscle weakness and facilitating weaning from mechanical ventilation

ObjectiveICU acquired muscle weakness (ICUAMW) is an acquired neuromuscular disorder associated with increased duration of mechanical ventilation and weaning suggesting a possible relation between the limb and respiratory neuromuscular involvement. There is no preventive tool and no specific treatment has been proposed for ICU acquired muscle weakness. Aim of this study was to assess the effect of electrical muscle stimulation on prevention of ICUAMW and in facilitating the weaning from mechanical ventilation in critically ill patients. DesignA prospective, randomized, placebo-controlled trial. SettingCritical care department, main Alexandria university hospital. Patients80 Critically ill patients on mechanical ventilation for more than 24 h. MethodsThey were randomly categorized into two groups: 40 patients received conventional lines of treatment only (control group) and 40 patients received in addition one daily session of Electrical Muscle Stimulation (EMS) (EMS group). Assessment of occurrence of ICUAMW was done through the MEDICAL RESEARCH COUNCIL SCALE (MRCS) which is a method for clinical assessment of muscle strength. ResultsMRCS did not show any significant difference between the two groups in the first 3 days post mechanical ventilation while on day 4, MRCS mean value was 46.86 ± 10.88 in the EMS group versus 43.70 ± 9.32 in the control group (p = 0.041). On day 21, MRCS mean value was 29.67 ± 8.87 in the EMS group versus 19.60 ± 4.34 in the control group (p = 0.037). Significant difference was also noted in the duration of mechanical ventilation as the mean value in the EMS group was 9.01 ± 8.01 days versus 11.97 ± 8.07 in the control group (p = 0.048). ConclusionsAlthough the EMS could not prevent the occurrence of ICUAMW in critically ill mechanically ventilated patients it still has a role in minimizing the degree of muscular weakness and could be helpful in facilitating weaning from mechanical ventilation.