Effect of neuromuscular electrical stimulation on functional exercise capacity in patients undergoing cardiac surgery: A randomized clinical trial

2021 ◽  
pp. 026921552110709
Author(s):  
Telma Cristina Fontes Cerqueira ◽  
Manoel Luiz de Cerqueira Neto ◽  
Lucas de Assis Pereira Cacau ◽  
Amaro Afrânio de Araújo Filho ◽  
Géssica Uruga Oliveira ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Electrical Stimulation ◽  
Postoperative Period ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Functional Independence Measure ◽  
Rectus Femoris ◽  
Functional Independence ◽  
Control Group ◽  
Electromyographic Activity

Objective To evaluate the effects of neuromuscular electrical stimulation on functional capacity of patients in the immediate postoperative period of cardiac surgery. Design A prospective, randomized controlled trial. Setting A cardiac surgery specialist hospital in Aracaju, Sergipe, Brazil. Subjects: Patients in the postoperative period of cardiac surgery. Intervention The control group received the conventional physiotherapy and the intervention group received neuromuscular electrical stimulation of the rectus femoris and gastrocnemius muscles bilaterally, applied for 60 min, twice a day for up to 10 sessions per patient, in the immediate postoperative period until postoperative day 5. Main measures The primary outcome was the distance walked, which was evaluated using the 6-min walk test on postoperative day 5. Secondary outcomes were gait speed, lactate levels, muscle strength, electromyographic activity of the rectus femoris and Functional Independence Measure, some of them evaluated on preoperative and postoperative period. Results Of 132 eligible patients, 88 patients were included and randomly allocated in two groups, and 45 patients were included in the analysis. No significant difference was found on the distance walked ( p = 0.650) between patients allocated in intervention group (239.06 ± 88.55) and control group (254.43 ± 116.67) as well as gait speed ( p = 0.363), lactate levels ( p = 0.302), knee extensor strength ( p = 0.117), handgrip strength ( p = 0.882), global muscle strength ( p = 0.104), electromyographic activity ( p = 0.179) and Functional Independence Measure ( p = 0.059). Conclusions Although the effects are still uncertain, the use of neuromuscular electrical stimulation carried out in five days didn't present any benefit on functional capacity of patients in the immediate postoperative period of cardiac surgery.

scholarly journals The Benefits of Neuromuscular Electrical Stimulation in the Muscular and Functional Capacity of Patients With Liver Cirrhosis: Protocol for a Randomized Clinical Trial

2018 ◽  
Vol 11 ◽  
pp. 117955221881183
Author(s):  
Carolina Luana de Mello ◽  
Thaís Martins Albanaz da Conceição ◽  
Tarcila Dal Pont ◽  
Catherine Corrêa Peruzzolo ◽  
Mariana Nunes Lúcio ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Pulmonary Function ◽  
Functional Capacity ◽  
Neuromuscular Electrical Stimulation ◽  
Rectus Femoris ◽  
Training Group ◽  
Functional Independence ◽  
Peripheral Muscle ◽  
Ultrasound Evaluation ◽  
Daily Physical Activities

Cirrhosis causes systemic and metabolic changes that culminate in various complications, such as compromised pulmonary function, ascites, hepatic encephalopathy, weight loss, and muscle weakness with significant physical function limitations. Our aim is to evaluate the effects of training with neuromuscular electrical stimulation (NMES) on the muscular and functional capacity of patients with cirrhosis classified as Child-Pugh B and C. A total of 72 patients diagnosed with cirrhosis will be recruited and randomized to perform an NMES protocol for 50 minutes, 3 times a week, for 4 weeks. The evaluations will be performed at the beginning and after 12 sessions, and patients will be submitted to a pulmonary function test, an ultrasound evaluation of the rectus femoris, an evaluation of peripheral muscle strength, a submaximal exercise capacity test associated with an evaluation of peripheral tissue oxygenation, a quality of life evaluation, and orientation about monitoring daily physical activities. The evaluators and patients will be blinded to the allocation of the groups. Training Group will be treated with the following parameters: frequency of 50 Hz, pulse width of 400 μs, rise and fall times of 2 s, and on:off 1:1; Sham Group: 5 Hz, 100 μs, on:off 1:3. The data will be analyzed using the principles of the intention to treat. This study provides health professionals with information on the benefits of this intervention. In this way, we believe that the results of this study could stimulate the use of NMES as a way of rehabilitating patients with more severe cirrhosis, with the objective of improving these patients’ functional independence.

Effect of adding neuromuscular electrical stimulation training to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: randomized clinical trial

2018 ◽  
Vol 33 (2) ◽  
pp. 195-206 ◽  
Author(s):  
Marwa Mekki ◽  
Thierry Paillard ◽  
Sonia Sahli ◽  
Zouhair Tabka ◽  
Yassine Trabelsi
Keyword(s):  
Electrical Stimulation ◽  
Pulmonary Rehabilitation ◽  
Center Of Pressure ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Berg Balance Scale ◽  
Voluntary Contraction ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Objective: To investigate the effectiveness of neuromuscular electrical stimulation added to pulmonary rehabilitation on walking tolerance and balance in patients with chronic obstructive pulmonary disease (COPD). Design: Randomized clinical trial. Setting: Outpatient, Faculty of Medicine of Sousse, Tunisia. Subjects: A total of 45 patients with COPD were assigned to an intervention group ( n = 25) or a control group ( n = 20). Interventions: The intervention group underwent a neuromuscular electrical stimulation added to pulmonary rehabilitation, and the control group underwent only a pulmonary rehabilitation, three times per week during six months. Main Measures: Measures were taken at baseline and after six months of training. A stabilometric platform, time up and go, Berg balance scale tests, 6 minute walking test, and the maximal voluntary contraction were measured. Results: In the intervention group, an increase in an exercise tolerance manifested by a longer distance walked in 6 minute walking test 619.5 (39.6) m was observed in comparison to the control group 576.3 (31.5) m. The values of the time up and go, Berg balance scale, and maximal voluntary contraction in the intervention group at follow-up were significantly higher than those in the control group ( P  = 0.02, P  = 0.01, P  = 0.0002, respectively). The center of pressure in the mediolateral and in the anteroposterior directions, as well as the center of pressure area was significantly more improved in open eyes and closed eyes in the intervention group compared to the control group ( P < 0.001). Conclusion: The neuromuscular electrical stimulation added to pulmonary rehabilitation group benefited from better walking tolerance and greater balance improvement than the only pulmonary rehabilitation.

Effectiveness of pre-surgical neuromuscular electrical stimulation on the recovery time of diaphyseal femoral fractures

2020 ◽  
Vol 27 (8) ◽  
pp. 1-15
Author(s):  
María C Bustos ◽  
María S Lo Presti
Keyword(s):  
Electrical Stimulation ◽  
Surgical Treatment ◽  
Recovery Time ◽  
Treatment Time ◽  
Waiting Times ◽  
Intervention Group ◽  
Neuromuscular Electrical Stimulation ◽  
Femoral Fractures ◽  
Control Group ◽  
Men And Women

Background/aims: Quadriceps pathology is common in patients who have suffered diaphyseal femoral fractures because of the long waiting times before surgery, during which they remain immobilised. The aim of this study was to evaluate the effectiveness of neuromuscular electrical stimulation applied in the pre-surgical period on the recovery time of the patients. Methods Before surgical treatment, patients with closed diaphyseal femoral fractures were systematically distributed alternatively into an intervention group and a control group. The intervention group (n=22) received pre-surgical neuromuscular electrical stimulation and the control group (n=25) received conventional physiokinetic treatment. Results Age, gender proportions and time between admission and surgery were similar in both groups. Average treatment time was 14.14 ± 9.7 days. Recovery time (from surgery to medical discharge) was 111 ± 15.65 days for participants in the intervention group, and 139.36 ± 23.05 days for participants in the control group (P<0.0001). No differences were found between men and women nor between the fractured femur (right vs left). Conclusions The results highlight the value of neuromuscular electrical stimulation in the pre-surgical period for patients with diaphyseal femoral fractures, optimising their rehabilitation and facilitating a quicker return to their everyday lives.

scholarly journals REACH AND PALMAR GRASP IN TETRAPLEGICS WITH NEUROMUSCULAR ELECTRICAL STIMULATION

2018 ◽  
Vol 24 (6) ◽  
pp. 450-454
Author(s):  
Enio Walker Azevedo Cacho ◽  
Roberta de Oliveira Cacho ◽  
Rodrigo Lício Ortolan ◽  
Núbia Maria Freire Vieira Lima ◽  
Edson Meneses da Silva Filho ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Neuromuscular Electrical Stimulation ◽  
Case Series ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Motor Patterns ◽  
Level Of Evidence ◽  
Infrared Cameras

ABSTRACT Objective: To evaluate the movement strategies of quadriplegics, assisted by neuromuscular electrical stimulation, on reach and palmar grasp using objects of different weights. Methods: It was a prospective clinical trial. Four chronic quadriplegics (C5-C6), with injuries of traumatic origin, were recruited and all of them had their reach and palmar grasp movement captured by four infrared cameras and six retro-reflective markers attached to the trunk and right arm, assisted or not by neuromuscular electrical stimulation to the triceps, extensor carpi radialis longus, extensor digitorum communis, flexor digitorum superficialis, opponens pollicis and lumbricals. It was measured by a Neurological and Functional Classification of Spinal Cord Injuries of the American Spinal Injury Association, Functional Independence Measure and kinematic variables. Results: The patients were able to reach and execute palmar grasp in all cylinders using the stimulation sequences assisted by neuromuscular electrical stimulation. The quadriplegics produced lower peak velocity, a shorter time of movement and reduction in movement segmentation, when assisted by neuromuscular electrical stimulation. Conclusion: This study showed that reach and palmar grasp movement assisted by neuromuscular electrical stimulation was able to produce motor patterns more similar to healthy subjects. Level of evidence IV; Case series.

Pedometers alone do not increase mobility in inpatient rehabilitation: a randomized controlled trial

2019 ◽  
Vol 33 (8) ◽  
pp. 1382-1390
Author(s):  
Amy Atkins ◽  
John Cannell ◽  
Christopher Barr
Keyword(s):  
Intervention Group ◽  
Functional Independence Measure ◽  
Inpatient Rehabilitation ◽  
Functional Independence ◽  
Functional Mobility ◽  
Step Count ◽  
Control Group ◽  
Randomized Controlled ◽  
Group A ◽  
Walking Velocity

Objective: To test if pedometers, as a motivational tool, could affect mobility outcomes in inpatient rehabilitation. Design: Randomized controlled clinical trial. Setting: Subacute hospital rehabilitation unit in Australia. Participants: A total of 78 participants with reduced mobility and clinician-determined capacity to improve. Interventions: Both groups received usual care. For the intervention group, a pedometer was worn on the hip with the step count visible to participant and recorded daily on an exercise log. For the control group, a pedometer fixed shut was worn on the hip and they recorded estimated distances walked on an exercise log. Main measures: Primary outcome was functional mobility – De Morton Mobility Index. Secondary outcome measures were walking velocity, functional independence measure, time spent upright and daily step count. Results: Significant improvements over time ( P < 0.001) in functional mobility, comfortable walking velocity and functional independence measure were not influenced by the intervention. The daily average upright time (hours) in the first week of intervention was different ( P = 0.004) between the intervention group (median, interquartile range (IQR): 1.67, 1.77) compared to the control group (median, IQR: 1.12, 0.82). Conclusion: Pedometers as a motivational tool without targets do not improve functional mobility in this population. Pedometers may improve daily upright time in this setting.

scholarly journals Effects of a Health Education program on cognition, mood and functional capacity

2017 ◽  
Vol 70 (4) ◽  
pp. 814-821 ◽  
Author(s):  
Juliane Cristine Dias ◽  
Isabela Azevedo Rodrigues ◽  
Francine Golghetto Casemiro ◽  
Diana Quirino Monteiro ◽  
Bruna Moretti Luchesi ◽  
...  
Keyword(s):  
Health Education ◽  
Group Dynamics ◽  
Functional Capacity ◽  
Intervention Program ◽  
Intervention Group ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Cognitive Stimulation ◽  
Control Group ◽  
Controlled Clinical Trial

ABSTRACT Objective: Assess the effect of a Health Education (HE) program on cognition, mood and functional capacity of participants in a University of The Third Age (U3A). Method: Controlled clinical trial. The HE Program consisted of 10 sessions with group dynamics, including orientations on disease prevention and cognitive stimulation exercises, lasting four months. Intervention Group (IG) n=13; and Control Group (CG) n=15. All were assessed at the start and end of the study, using Addenbrook´s Cognitive Examination-Revised (ACE-R), Beck Depression and Anxiety Inventory (BDI/BAI) and Functional Independence Measure (FIM). Results: Significant improvements were observed for the IG when comparing the total ACE-R score (p=0.001) and memory domain (p=0.011) before and after the intervention. For the CG, improvement was found in the memory domain only (p=0.027). Conclusion: a HE intervention program benefits the improvement in cognitive performance, particularly the memory of adults and active elderly who participated in a U3A.

Can rehabilitation improve the health and well-being in Friedreich’s ataxia: a randomized controlled trial?

2017 ◽  
Vol 32 (5) ◽  
pp. 630-643 ◽  
Author(s):  
Sarah C Milne ◽  
Louise A Corben ◽  
Melissa Roberts ◽  
Anna Murphy ◽  
Geneieve Tai ◽  
...  
Keyword(s):  
Friedreich Ataxia ◽  
Intervention Group ◽  
Functional Independence Measure ◽  
Well Being ◽  
Functional Independence ◽  
Friedreich’S Ataxia ◽  
Friedreich's Ataxia ◽  
Home Exercise ◽  
Control Group ◽  
Health And Well Being

Objective: To determine the effectiveness of a six-week rehabilitation programme followed by a home exercise programme for Friedreich’s ataxia. Design: Randomized, delayed-start control single-blind trial. Setting: Outpatient rehabilitation centre. Subjects: Ambulant or non-ambulant individuals with Friedreich’s ataxia. Intervention: Participants were randomized to a six-week outpatient rehabilitation programme, immediately (intervention group) or after a six-week delayed-start (control group). The rehabilitation was followed by a six-week home exercise programme. Main measures: The primary outcome was the Functional Independence Measure. Other measures included the Friedreich Ataxia Impact Scale and the Friedreich Ataxia Rating Scale. Outcomes were administered at baseline, 6, 12 and 18 weeks. Results: Of 159 individuals screened, 92 were excluded and 48 declined to participate. A total of 19 participants were enrolled in the study. There was no significant difference in Functional Independence Measure change from baseline to six weeks in the intervention group (mean ± standard deviation, 2.00 ± 3.16) as compared to the control group (0.56 ± 4.06). Change in the Friedreich Ataxia Impact Scale body movement subscale indicated a significant improvement in health and well-being in the intervention group compared to the control group ( P = 0.003). Significant within-group improvements in the Friedreich Ataxia Impact Scale and the motor domain of the Functional Independence Measure post-rehabilitation were not sustained post-home exercise programme. Conclusion: Our study indicates that rehabilitation can improve health and well-being in individuals with Friedreich’s ataxia; however, a larger study is required to have sufficient power to detect a significant change in the most sensitive measure of function, the motor domain of the Functional Independence Measure.

scholarly journals Assessment of Acupuncture and Moxibustion Effects on the Electrophysiological Properties of the Ulnar Nerve: A Nerve Conduction Study

2018 ◽  
Vol 4 (3-4) ◽  
pp. 198-207 ◽  
Author(s):  
Sónia Chan ◽  
Sérgio Ferreira ◽  
Bruno Ramos ◽  
Maria João Santos ◽  
Luís Carlos Matos ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Ulnar Nerve ◽  
Rating Scale ◽  
Intervention Group ◽  
Maximum Amplitude ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Reaction Velocity ◽  
Electrophysiological Properties ◽  
Acupuncture And Moxibustion

Background/Aims: Acupuncture and moxibustion, when used together, have act mechanically and thermally on treated reflexological areas. The main goal of this work was to evaluate the effects of acupuncture and moxibustion on the electrophysiological properties of the ulnar nerve. Methods: Electrical stimulation was applied to the ulnar nerve above the epi­condyle of 28 volunteers. A 20-V potential was applied, and after each 10 impulses it was increased by 10 V, up to a maximum of 80 V. At 20 and 80 V, the participants were asked to rate the discomfort from 0 to 10 on a Numeric Rating Scale for pain. After the first stimulation and data collection, the control group rested for 6 min, while the intervention group was submitted to acupuncture and moxibustion on Lingdao (HT 4). Following this period of time, a second electrical stimulation was performed on both groups. Results: The discomfort was greater in the intervention group during the second stimulation. The stimulus required to achieve the maximum amplitude decreased, but the changes were only statistically significant in the intervention group (p = 0.006). An increase in latency and a decrease in reaction velocity were noticed between the first and the second stimulation for both groups; however, only the control group presented statistically significant differences (p = 0.018 and p = 0.022, respectively). Conclusions: Acupuncture and moxibustion on HT 4 increased the electrical sensitivity, decreased the stimulus intensity to achieve the maximum amplitude, and avoided a significant increase in latency and decrease in reaction velocity in two consecutive electrical stimulations.

Does Neuromuscular Electrical Stimulation Have an Additive Effect on Disability, Pain and Abdominal and Lumbar Muscle Thickness in Chronic Low Back Pain? – A Randomized Controlled Double-Blind Study

2021 ◽  
Author(s):  
Ecenur Atli ◽  
Dilber Karagozoglu Coskunsu ◽  
Zeynep Turan ◽  
Ozden Ozyemisci Taskiran
Keyword(s):  
Electrical Stimulation ◽  
Low Back Pain ◽  
Back Pain ◽  
Outcome Measures ◽  
Chronic Low Back Pain ◽  
Neuromuscular Electrical Stimulation ◽  
Muscle Thickness ◽  
Transversus Abdominis ◽  
Control Group ◽  
Low Back

Abstract Objective To examine the effect of neuromuscular electrical stimulation (NMES) combined with core stabilization exercises (CSE) in patients with chronic low back pain (CLBP). Methods Thirty-six patients (mean age 33.6±12.6 years) with CLBP were randomly assigned to 4 weeks (12 sessions) of NMES group (NMES combined with CSE) (n=18) vs. Control group (sham NMES and CSE) (n=18). After the 4 weeks, same exercises were given as home exercise program without NMES. The outcome measures were Oswestry Disability Index (ODI), Visual Analog Scale (VAS), Nottingham Health Profile (NHP) and ultrasonography. Ultrasonography was used for measuring transversus abdominis (TrA), internal oblique (IO), external oblique (EO) muscles thickness and lumbar multifidus muscle thickness and area. Assessments were performed at baseline and 4th week and eighth week follow-up. Results In both groups, the change of ODI, VAS and NHP values of the first measurement according to the values of the 4th week and the eighth week were found statistically significant (p=0.001; p<0.01). There were no statistically significant differences in ODI, VAS and NHP scores between the 4th week and the eighth week in both groups (p>0.05). None of NMES and control group measurements with US showed a statistically significant increase in the TrA, IO, EO thickness and multifidus thickness and area (p>0.05). Conclusions It was shown that NMES can be tolerated by patients with CLBP, but the addition of simultaneus NMES to CSE had no contribution to the clinical outcome measures.

Cerebral Oximetry Monitoring to Maintain Normal Cerebral Oxygen Saturation during High-risk Cardiac Surgery

2016 ◽  
Vol 124 (4) ◽  
pp. 826-836 ◽  
Author(s):  
Alain Deschamps ◽  
Richard Hall ◽  
Hilary Grocott ◽  
C. David Mazer ◽  
Peter T. Choi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intervention Group ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Cerebral Oxygen ◽  
Cerebral Desaturation ◽  
Cerebral Saturation

Abstract Background Cerebral oxygen desaturation during cardiac surgery has been associated with adverse perioperative outcomes. Before a large multicenter randomized controlled trial (RCT) on the impact of preventing desaturations on perioperative outcomes, the authors undertook a randomized prospective, parallel-arm, multicenter feasibility RCT to determine whether an intervention algorithm could prevent desaturations. Methods Eight Canadian sites randomized 201 patients between April 2012 and October 2013. The primary outcome was the success rate of reversing cerebral desaturations below 10% relative to baseline in the intervention group. Anesthesiologists were blinded to the cerebral saturation values in the control group. Intensive care unit personnel were blinded to cerebral saturation values for both groups. Secondary outcomes included the area under the curve of cerebral desaturation load, enrolment rates, and a 30-day follow-up for adverse events. Results Cerebral desaturations occurred in 71 (70%) of the 102 intervention group patients and 56 (57%) of the 99 control group patients (P = 0.04). Reversal was successful in 69 (97%) of the intervention group patients. The mean cerebral desaturation load (SD) in the operating room was smaller for intervention group patients compared with control group patients (104 [217] %.min vs. 398 [869] %.min, mean difference, −294; 95% CI, −562 to −26; P = 0.03). This was also true in the intensive care unit (P = 0.02). There were no differences in adverse events between the groups. Conclusions Study sites were successful in reversal of desaturation, patient recruitment, randomization, and follow-up in cardiac surgery, supporting the feasibility of conducting a large multicenter RCT.

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