Abstract
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases
Introduction
The purpose was to evaluate the effectiveness of NMES in patients with complications after cardiac surgery.
Methods
This study was 37 patients who had significant postoperative complications after cardiovascular surgery. Participants were randomly - NMES group, n = 18; control, n = 19. It was not possible to blind the investigator. Analyzed basic clinical data. The dynamometry of the muscles upper and lower extremities was carried out, as well as a 6-minute walk test (6MWT). Also, the thickness of the quadriceps was measured using ultrasound.The patients underwent NMES on the quadriceps femoris muscle, daily from the third postoperative day, until discharge. The duration session was 90 minutes.
Outcomes
No differences were found in the baseline characteristics of the groups, including the results of laboratory and instrumental studies. Groups were comparable in the surgery and perioperative parameteres. The initial strength indicators also had no significant differences in the groups.
At discharge knee extensors strength (KES) was significantly higher in the NMES group. The knee flexor strength (KFS) and handgrip strength (HF) increased the same in both groups. The quadriceps crosssectional area (CSA) muscle increased more in the NEMS group than in the control to the time of discharge. Average KES increased to a greater extent in the NMES group. At the same time, average and maximum KFS increased equally in both groups. A 6MWT before discharge did not show a difference between groups (P=.166). The NMES course did not affect the duration of hospitalisation (P=.429).
Discussion
This pilot study show beneficial effects of NMES on muscle strength in patients with complications after cardiovascular surgery.
Physical tests initially and in dynamics NEMS Group (n = 18) Control group (n = 19) Baseline Discharge Baseline Discharge P-level Right knee extensors strength (kg) 20,3 [17,9; 26,1] 28,05 [23,8; 36,2] * 20,1 [18,6; 25,4] 22,3 [20,1; 27,1] * 0,004 Left knee extensors strength (kg) 17,75 [15,5; 27,0] 27,45 [22,3; 33,1] * 20,8 [17,5; 24,2] 22,5 [20,1; 25,9] * 0,017 Right knee flexors strength (kg) 14,85 [11,7; 19,5] 17,5 [14,1; 23,4] * 16,9 [13,1; 23,8] 19,2 [12,5; 26,4] * 0,971 Left knee flexors strength (kg) 14,7 [12,6; 19,6] 19,75 [15,9; 24,2] * 16,2, [10,4; 25,1] 18,8 [13,1; 27,7] * 0,889 6-MWT (m) 148,5 [108,5; 174,0] 288,0 [242,0; 319,0] * 169,0 [115,0; 217,0] 315,0 [277,0; 400,0] * 0,166 Right handgrip strength (kg) 24,5 [15,0; 33,0] 25,5 [19,0; 36,0] * 27,0 [18,0; 32,0] 30,0 [20,0; 35,0] * 0,795 Left handgrip strength (kg) 17,0 [12,0; 27,0] 21,0 [15,0; 31,0] * 19,0 [14,0; 29,0] 23,0 [16,0; 30,0] * 0,541 * - p-level from baseline data < 0,05 ** - p-level from baseline data ≥ 0,05
Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery
