新規理学療法ジャーナル

抽象的な

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

Dharam Pani Pandey, Ram Babu and Esha Arora

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.