EFFECTS OF NEUROMUSCULAR ELECTRICAL STIMULATION ON MUSCLE LAYER THICKNESS OF KNEE EXTENSOR MUSCLES IN INTENSIVE CARE UNIT PATIENTS: A PILOT STUDY
EFFECTS OF NEUROMUSCULAR ELECTRICAL STIMULATION ON MUSCLE LAYER THICKNESS OF KNEE EXTENSOR MUSCLES IN INTENSIVE CARE UNIT PATIENTS: A PILOT STUDY
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DOI：
10.2340/16501977-0564
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发表时间：
2010-06-01
影响因子：
3.5
通讯作者：
Crevenna, Richard
中科院分区：
文献类型：
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作者：
Gruther, Wolfgang;Kainberger, Franz;Crevenna, Richard
目的：众所周知，重症监护病房的患者肌肉质量出现巨大损失。神经肌肉电刺激可有效增强固定患者的力量和耐力。本研究的目的是评估神经肌肉电刺激对重症监护病房患者膝关节伸肌肌层厚度的影响。设计：随机、对照、双盲预试验。患者：33名患者，男女比例26:7，平均年龄55岁（标准差15）。方法：入组后，重症监护病房患者（主要诊断：多发伤、心血管疾病、移植、肺炎、癌症）被分层（根据住院时间）分为2组：17名急性患者（<7天）和16名长期患者（>14天） 天）。两组均随机分为刺激组或假刺激组。对膝伸肌进行神经肌肉电刺激，为期 4 周（疗程时间 30-60 分钟，每周 5 天）。在刺激期之前和之后进行超声测量，以量化膝伸肌的肌层厚度。结果：与假刺激患者 (-3.2%) 相比，仅长期刺激的患者 (+4.9%) 表现出肌肉层厚度显着 (p=0.013) 增加。结论：神经肌肉电刺激似乎是恢复重症监护病房长期患者肌肉萎缩的有效辅助手段；然而，需要更大样本量的更大规模研究来证实这些有希望的但初步的结果。
Objective: It is known that patients in the intensive care unit show an enormous loss of muscle mass. Neuromuscular electrical stimulation is effective in enhancing strength and endurance in immobilized patients. The aim of this study was to evaluate the effects of neuromuscular electrical stimulation on muscle layer thickness of knee extensor muscles in intensive care unit patients.Design: Randomized, controlled, double-blind, pilot trial. Patients: Thirty-three patients, male to female ratio 26:7, mean age 55 years (standard deviation 15).Methods: After enrolment in the study, intensive care unit patients (main diagnoses: polytrauma, cardiovascular diseases, transplantation, pneumonia, cancer) were stratified (based on the length of their stay in hospital) into 2 groups: 17 acute patients (< 7 days) and 16 long-term patients (> 14 days). Both groups were randomized to a stimulation group or a sham-stimulation group. Neuromuscular electrical stimulation was applied to knee extensor muscles for a period of 4 weeks (session time 30-60 minutes, 5 days/week). Ultrasound measurements were performed before and after the stimulation period to quantify muscle layer thickness of knee extensor muscles.Results: Only stimulated long-term patients (+4.9%) showed a significant (p=0.013) increase in muscle layer thickness compared with sham-stimulated patients (-3.2%). Conclusion: Neuromuscular electrical stimulation appears to be a useful adjunct to revert muscle wasting in intensive care unit long-term patients; however, larger studies with a larger sample size are needed to confirm these promising, but preliminary, results.