Neuromuscular electrical stimulation for preventing skeletal-muscle weakness and wasting in critically ill patients: a systematic review

BMC Medicine

Serafim Nanas¹  Eleftherios Karatzanos¹  Marc Roig³  Nicola A Maffiuletti² 

[1] First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece;Neuromuscular Research Laboratory, Schulthess Clinic, Zurich, Switzerland;Department of Exercise and Sport Sciences and Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark

关键词: Rehabilitation;    Sepsis;    Intensive care;    Quadriceps femoris;    Muscle mass;    Muscle strength;   

Others  :  857014
DOI  :  10.1186/1741-7015-11-137

 received in 2012-11-26, accepted in 2013-04-19,  发布年份 2013

【 摘 要 】

Background

Neuromuscular electrical stimulation (NMES) therapy may be useful in early musculoskeletal rehabilitation during acute critical illness. The objective of this systematic review was to evaluate the effectiveness of NMES for preventing skeletal-muscle weakness and wasting in critically ill patients, in comparison with usual care.

Methods

We searched PubMed, CENTRAL, CINAHL, Web of Science, and PEDro to identify randomized controlled trials exploring the effect of NMES in critically ill patients, which had a well-defined NMES protocol, provided outcomes related to skeletal-muscle strength and/or mass, and for which full text was available. Two independent reviewers extracted data on muscle-related outcomes (strength and mass), and participant and intervention characteristics, and assessed the methodological quality of the studies. Owing to the lack of means and standard deviations (SDs) in some studies, as well as the lack of baseline measurements in two studies, it was impossible to conduct a full meta-analysis. When means and SDs were provided, the effect sizes of individual outcomes were calculated, and otherwise, a qualitative analysis was performed.

Results

The search yielded 8 eligible studies involving 172 patients. The methodological quality of the studies was moderate to high. Five studies reported an increase in strength or better preservation of strength with NMES, with one study having a large effect size. Two studies found better preservation of muscle mass with NMES, with small to moderate effect sizes, while no significant benefits were found in two other studies.

Conclusions

NMES added to usual care proved to be more effective than usual care alone for preventing skeletal-muscle weakness in critically ill patients. However, there is inconclusive evidence for its benefit in prevention of muscle wasting.

【 授权许可】

   
2013 Maffiuletti et al.; licensee BioMed Central Ltd.

【 图 表 】

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