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October 17, 2024World Journal of CardiologyOpen Access

Evaluating neuromuscular electrical stimulation for preventing and managing intensive care unit-acquired weakness: Current evidence and future directions

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Key result

Multipath neuromuscular electrical stimulation achieved significantly higher maximal current intensity (55 vs 46 mA, p<0.001) and lower discomfort compared to conventional stimulation in obese patients with obstructive sleep apnea.

Why the study?

Intensive care unit-acquired weakness leads to significant muscle atrophy and functional impairment, prompting evaluation of neuromuscular electrical stimulation as a therapeutic option.

Does multipath NMES improve stimulation tolerance and evoked muscle force compared to conventional NMES in severely obese patients with obstructive sleep apnea?

Population

Pre- and post-cardiac surgery patients

Comparison

Neuromuscular Electrical Stimulation vs comparator not stated

Design

Systematic review

Authors

AKAnnu Lisa KurianBLBrandon Lucke‐Wold

Discussion

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Overview

Multipath NMES improves tolerance and permits higher intensities versus conventional NMES in obese OSA patients; extends NMES options in this population.

Study Design

Type

RCT (n=12)

Blinding

Open-label

Randomization

Cross-over

Multicenter

No

Structured PICO

Does multipath NMES improve stimulation tolerance and evoked muscle force compared to conventional NMES in severely obese patients with obstructive sleep apnea?

P
Population
12 extremely inactive obese adults with treated obstructive sleep apnea who underwent two 20-minute sessions of different neuromuscular electrical stimulation modalities.
I
Intervention
Multipath Neuromuscular Electrical Stimulation (NMES) for a single 20-minute session at maximal tolerable intensity (50 Hz, 400 μs pulse duration)
C
Comparator
Conventional NMES for a single 20-minute session at maximal tolerable intensity (50 Hz, 400 μs pulse duration) in a cross-over design
O
Outcome
Feasibility outcomes including NMES current intensity, knee extension force evoked by NMES (% of maximal voluntary contraction), and self-reported discomfort (VAS)surrogate

Main Result

Mean Difference: 8.9

Absolute Event Rate: 55% vs 46%

p-value: p=<0.001

Multipath NMES is feasible and better tolerated than conventional NMES in severely obese patients with obstructive sleep apnea, allowing for higher stimulation intensities.

Limitations

  • Small sample size of 12 patients
  • Acute single-session design does not assess long-term effects
  • Open-label design may introduce bias in self-reported discomfort and intensity tolerance
  • Excessive subcutaneous adipose tissue limits current penetration
  • Small sample size
  • Acute single-session design
  • Excessive subcutaneous adipose tissue acting as a physiological barrier to NMES effectiveness

Cite This Study

Kurian et al. (2024) conducted an RCT in Obesity and obstructive sleep apnea (n=12). Multipath neuromuscular electrical stimulation vs. Conventional neuromuscular electrical stimulation was evaluated on Maximal tolerable current intensity (mA) (MD 8.9, p=<0.001). Multipath neuromuscular electrical stimulation achieved significantly higher maximal current intensity (55 vs 46 mA, p<0.001) and lower discomfort compared to conventional stimulation in obese patients with obstructive sleep apnea.

synapsesocial.com/papers/6a984eecd72f642c28a673f3https://doi.org/10.4330/wjc.v16.i10.604
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1An Official American Thoracic Society Clinical Practice Guideline: The Diagnosis of Intensive Care Unit–acquired Weakness in Adults2014 · 558 citations
  2. 2Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery: A systematic review2024 · 8 citations
  3. 3The 6-Minute Walk Test predicts long-term physical improvement among intensive care unit survivors: a prospective cohort study2021 · 10 citations
  4. 4Review of the effectiveness of neuromuscular electrical stimulation in the treatment of dysphagia – an update2022 · 25 citations
  5. 5Neuromuscular electrical stimulation‐promoted plasticity of the human brain2019 · 144 citations