Post-operative electrical muscle stimulation attenuates loss of muscle mass and function following major abdominal surgery in older adults: a split body randomised control trial.
Post-operative electrical muscle stimulation attenuates loss of muscle mass and function following major abdominal surgery in older adults: a split body randomised control trial.
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DOI：
10.1093/ageing/afac234
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发表时间：
2022-10-06
期刊：
影响因子：
6.7
通讯作者：
中科院分区：
文献类型：
--
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腹部大手术后，肌肉质量和功能会发生显著损失。神经肌肉电刺激（NMES）已被证明可以减少某些患者组的肌肉萎缩，但在术后患者中的证据有限。本研究评估了NMES减轻老年人腹部大手术后肌肉萎缩和功能下降的疗效。15例接受开放性结直肠切除术的患者完成了一项劈体随机对照试验。患者的下肢被随机分配至对照组（CON）或NMES组（STIM）。在术后第1-4天（POD），STIM肢体接受了15分钟的股四头肌NMES，每天两次。术前和术后第5天进行股外侧肌横截面积（CSA）和肌肉厚度（MT）的超声测量，并进行测力术以确定膝关节伸肌力量（KES）。CSA的变化是主要结局。使用线性混合模型对所有结局进行统计分析。NMES显著降低了CSA的损失（−2.52 vs − 9.16%，P < 0.001），MT（−2.76 vs −8.145，P = 0.001）和KES（−10.35 vs − 19.69%，P = 0.03）与CON相比。未发生不良事件，患者报告称NMES引起的不适极小或无不适，并认为每天约90分钟的NMES是可耐受的。NMES减少了腹部大手术后肌肉质量和功能的损失，因此，可能是术后恢复的有前途的工具。这对于预防术后长期依赖性非常重要，特别是在接受腹部大手术的日益虚弱的老年患者中。进一步的研究应确定双侧NMES改善以患者为中心的结局的有效性。
Significant losses of muscle mass and function occur after major abdominal surgery. Neuromuscular electrical stimulation (NMES) has been shown to reduce muscle atrophy in some patient groups, but evidence in post-operative patients is limited. This study assesses the efficacy of NMES for attenuating muscle atrophy and functional declines following major abdominal surgery in older adults. Fifteen patients undergoing open colorectal resection completed a split body randomised control trial. Patients’ lower limbs were randomised to control (CON) or NMES (STIM). The STIM limb underwent 15 minutes of quadriceps NMES twice daily on post-operative days (PODs) 1–4. Ultrasound measurements of Vastus Lateralis cross-sectional area (CSA) and muscle thickness (MT) were made preoperatively and on POD 5, as was dynamometry to determine knee extensor strength (KES). Change in CSA was the primary outcome. All outcomes were statistically analysed using linear mixed models. NMES significantly reduced the loss of CSA (−2.52 versus −9.16%, P < 0.001), MT (−2.76 versus −8.145, P = 0.001) and KES (−10.35 versus −19.69%, P = 0.03) compared to CON. No adverse events occurred, and patients reported that NMES caused minimal or no discomfort and felt that ~90-minutes of NMES daily would be tolerable. NMES reduces losses of muscle mass and function following major abdominal surgery, and as such, may be the promising tool for post-operative recovery. This is important in preventing long-term post-operative dependency, especially in the increasingly frail older patients undergoing major abdominal surgery. Further studies should establish the efficacy of bilateral NMES for improving patient-centred outcomes.
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影响因子：
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3.1
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DOI：
10.1097/mco.0b013e328337819e
发表时间：
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影响因子：
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