Department of Cardiovascular Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People's Republic of China.
Department of Nursing, The Affiliated Hospital, Southwest Medical University, Luzhou, 646000, People's Republic of China.
Clin Interv Aging. 2024 Jul 1;19:1163-1176. doi: 10.2147/CIA.S460805. eCollection 2024.
A global public health problem, frailty is closely associated with poor prognosis after percutaneous coronary intervention (PCI) in older patients with acute myocardial infarction (AMI). Although exercise intervention is the most commonly used method to reverse and alleviate frailty, its application is restricted in patients with acute myocardial infarction following PCI due to cardiovascular instability and autonomic imbalance. Consequently, there is a need for a new practical intervention to address frailty syndrome in these patients.
This study aimed to investigate the effect of neuromuscular electrical stimulation in frail older AMI patients post-PCI.
A single-blind, randomized controlled trial was carried out in the Department of Cardiovascular Medicine from March to October 2023. A total of 100 eligible participants were randomly divided into two groups: experimental (n = 50) and control (n = 50) groups, respectively. Both groups received usual care. The experimental group underwent neuromuscular electrical stimulation (NMES) on bilateral quadriceps and gastrocnemius muscles for 30 minutes daily from day 1 to day 7 after surgery. The primary outcomes measured included the frailty score, lower limb muscle strength, and lower limb muscle quality. Secondary outcomes included the activities of daily living score, inflammatory markers, and length of hospital stay. All participants were included in an intention-to-treat analysis after the study ended.
The frailty scores of the two groups exhibited a gradual decrease over time, and the scores of the experimental group were lower than those of the control group at 4 and 7 days after surgery (P<0.001). Concurrently, the lower limb muscle strength showed an increasing trend over the time in the experimental group and a decreasing trend in the control group, and the scores of the experimental group surpassed those of the control group (p<0.001). Moreover, a statistical difference was observed in the lower limb muscle mass across the groups after 7 days postoperatively compared with baseline on both sides (p<0.05).
Neuromuscular electrical stimulation has the potential to enhance lower limb function and alleviate frailty in elderly patients with acute myocardial infarction after PCI. These findings introduce a novel intervention approach for frailty management in the elderly population.
衰弱是一个全球性的公共卫生问题，与老年急性心肌梗死（AMI）患者经皮冠状动脉介入治疗（PCI）后的不良预后密切相关。尽管运动干预是逆转和缓解衰弱最常用的方法，但由于心血管不稳定和自主神经失衡，在 PCI 后发生急性心肌梗死的患者中应用受限。因此，需要一种新的实用干预措施来解决这些患者的衰弱综合征。
本研究旨在探讨神经肌肉电刺激对 PCI 后衰弱老年 AMI 患者的影响。
2023 年 3 月至 10 月，在心血管医学科进行了一项单盲、随机对照试验。共纳入 100 名符合条件的参与者，随机分为实验组（n=50）和对照组（n=50）。两组均接受常规护理。实验组术后第 1 天至第 7 天每天接受双侧股四头肌和小腿三头肌神经肌肉电刺激 30 分钟。主要结局指标包括衰弱评分、下肢肌肉力量和下肢肌肉质量。次要结局指标包括日常生活活动评分、炎症标志物和住院时间。研究结束后，所有参与者均进行意向治疗分析。
两组的衰弱评分随时间逐渐下降，术后第 4 天和第 7 天实验组评分低于对照组（P<0.001）。同时，实验组下肢肌肉力量随时间呈上升趋势，对照组呈下降趋势，实验组评分高于对照组（P<0.001）。此外，与基线相比，术后第 7 天两组双侧下肢肌肉质量均有统计学差异（p<0.05）。
神经肌肉电刺激可增强 PCI 后老年急性心肌梗死患者的下肢功能，缓解衰弱。这些发现为老年人衰弱管理引入了一种新的干预方法。
