Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21287; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada L8S 1C7.
Pulmonary, Allergy, and Critical Care Medicine, Emory University, Atlanta, GA 30308.
J Crit Care. 2015 Feb;30(1):32-9. doi: 10.1016/j.jcrc.2014.09.014. Epub 2014 Sep 22.
The purpose of the study is to compare neuromuscular electrical stimulation (NMES) vs sham on leg strength at hospital discharge in mechanically ventilated patients.
We conducted a randomized pilot study of NMES vs sham applied to 3 bilateral lower extremity muscle groups for 60 minutes daily in the intensive care unit (ICU). Between June 2008 and March 2013, we enrolled adults who were receiving mechanical ventilation within the first week of ICU stay and who could transfer independently from bed to chair before hospital admission. The primary outcome was lower extremity muscle strength at hospital discharge using Medical Research Council score (maximum, 30). Secondary outcomes at hospital discharge included walking distance and change in lower extremity strength from ICU awakening. Clinicaltrials.gov: NCT00709124.
We stopped enrollment early after 36 patients due to slow patient accrual and the end of research funding. For NMES vs sham, mean (SD) lower extremity strength was 28 (2) vs 27 (3), P = .072. Among secondary outcomes, NMES vs sham patients had a greater mean (SD) walking distance (514 [389] vs 251 [210] ft, P = .050) and increase in muscle strength (5.7 [5.1] vs 1.8 [2.7], P = .019).
In this pilot randomized trial, NMES did not significantly improve leg strength at hospital discharge. Significant improvements in secondary outcomes require investigation in future research.
本研究旨在比较神经肌肉电刺激（NMES）与假刺激对机械通气患者出院时腿部力量的影响。
我们进行了一项 NMES 与假刺激的随机试点研究，将其应用于重症监护病房（ICU）中 3 个双侧下肢肌肉群，每天 60 分钟。在 2008 年 6 月至 2013 年 3 月期间，我们招募了在 ICU 住院第一周内接受机械通气且在入院前能够独立从床转移到椅子的成年人。主要结局指标是使用医学研究理事会评分（最高 30 分）评估出院时下肢肌肉力量。出院时的次要结局指标包括行走距离和 ICU 觉醒时下肢力量的变化。Clinicaltrials.gov：NCT00709124。
由于患者入组缓慢和研究资金结束，我们在 36 例患者后提前停止了入组。对于 NMES 与假刺激，下肢力量的平均（SD）分别为 28（2）与 27（3），P=.072。在次要结局方面，NMES 与假刺激患者的平均（SD）行走距离（514[389]与 251[210]英尺，P=.050）和肌肉力量增加（5.7[5.1]与 1.8[2.7]，P=.019）更大。
在这项试点随机试验中，NMES 并未显著改善出院时的腿部力量。需要进一步的研究来调查次要结局的显著改善。
