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Comparison of gastrocnemius muscle strength before and after treatment. a Decrease of gastrocnemius muscle strength before and after treatment in the three groups. b Gastrocnemius muscle strength gap before and after treatment among the three groups. Exp I: experimental group I, Exp II: experimental group II, Ctl: control group; Bef: before treatment, Aft: after treatment; * P < 0.05 between each group before and after treatment; #P < 0.05 vs. control group
Source publication
Background:
Extensive muscle atrophy is a common occurrence in orthopaedics patients who are bedridden or immobilized. The incidence is higher in intensive care unit (ICU) inpatients. There is still controversy about how to use neuromuscular electrical stimulation (NMES) in ICU patients. We aim to compare the effectiveness and safety of NMES to pr...
Citations
... HHD adalah alat yang ampuh untuk menilai kekuatan otot pada pasien myositis. (Bao, Yang, Li, Chen, Ma, Bai, & Xu, 2022). ...
... Frekuensi transduser dipertahankan pada 6 MHz dengan pengaturan penguatan, kompresi, dan offset waktu yang konstan. Data USG disimpan secara digital dalam sistem USG dan diproses secara offline (Bao et al., 2022). sEIM dilakukan pada awal dan setelah 12 dan 24 bulan menggunakan perangkat ImpediMed, yang sebelumnya digunakan untuk mengevaluasi penyakit neuromuskular. ...
... Terdapat tren yang berkembang untuk menangani pasien dengan ventilasi mekanis dengan pengurangan sedasi dan untuk memobilisasi dan merehabilitasi mereka segera setelah masuk ke unit perawatan intensif (Bao et al., 2022). Atrofi muskuloskeletal terjadi pada awal fase akut perawatan ICU. ...
Background: Patients treated in the intensive care unit often experience decreased muscle strength. Continuous muscle weakness will affect muscle condition and have a bad impact and can cause disability. Health workers can use technology to measure muscle strength. Purpose: To examine in depth the technology for measuring muscle strength in critical patients. Method: Scoping review research was conducted in March 2023 using PubMed, ScienceDirect, Scopus, and ProQuest databases published in 2018-2023. Identified and selected through the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. The inclusion criteria used include muscle strength measurement technology and research participants in critical patients, articles published between 2018-2023, articles that are open access, in English, and relevant. Screening and selection of articles was carried out on the title and abstract, eliminating duplicate articles, articles with full text, according to the research field, type of method, randomized controlled trials and systematic reviews. Results: Identified 663 articles and obtained 10 relevant articles for analysis summarizing the development of technology for measuring muscle strength in critical patients, the nursing implications of technology in assessing muscle strength, and the ease and use of technology in measuring muscle strength. Conclusion: Technological developments have a positive impact on patient treatment, especially for patients with critical conditions who require fast and appropriate treatment so that their quality of life can improve. Utilizing technological developments in accurately measuring muscle strength in critical patients can have a positive impact in selecting the appropriate patient treatment and rehabilitation process as well as preventing complications or muscle contractures. Suggestion: Further research regarding technological innovations in muscle strength in critical patients’ needs to be carried out in more depth because it is useful in helping nurses and health service providers in measuring muscle strength in critical patients, so that it is beneficial for critical patients and provides accurate and valid muscle strength measurement results. Keywords: Critical Patients; Measurement; Muscle Strength; Technology. Pendahuluan: Pasien yang dirawat di ICU sering mengalami penurunan kekuatan otot. Kelemahan otot yang terus menerus akan mempengaruhi kondisi otot dan berdampak buruk serta dapat menyebabkan kecacatan. Penggunaan teknologi dapat dimanfaatkan oleh tenaga kesehatan dalam pengukuran kekuatan otot. Tujuan: Untuk mengkaji secara mendalam teknologi dalam pengukuran kekuatan otot pada pasien kritis. Metode: Penelitian scoping review dilakukan pada bulan Maret 2023 melalui database PubMed, ScienceDirect, Scopus, dan ProQuest terbitan tahun 2018-2023. Diidentifikasi dan diseleksi melalui Preferred Reporting Items for Systematic Review and Meta-Analysis for Scoping Review guideline (PRISMA-ScR). Kriteria inklusi yang digunakan adalah memuat teknologi pengukuran kekuatan otot dan partisipan penelitian pada pasien kritis, artikel diterbitkan antara tahun 2018-2023, artikel bersifat open acces, berbahasa Inggris, dan relevan. Penyaringan dan pemilihan artikel dilakukan pada judul dan abstrak, menghapus artikel duplikat, artikel dengan teks lengkap, sesuai dengan bidang penelitian, jenis metode randomized controlled trial dan systematic review. Hasil: Mengidentifikasi 663 artikel dan mendapatkan 10 artikel relevan untuk dianalisis merangkum tentang perkembangan teknologi pengukuran kekuatan otot pada pasien kritis, implikasi keperawatan terhadap teknologi dalam penilaian kekuatan otot, dan kemudahan serta penggunaan teknologi dalam pengukuran kekuatan otot. Simpulan: Perkembangan teknologi memberikan dampak positif terhadap pengobatan pasien, terutama pada pasien dengan kondisi kritis yang memerlukan pengobatan cepat dan tepat agar kualitas hidupnya dapat ditingkatkan. Penggunaan perkembangan teknologi dalam pengukuran kekuatan otot secara akurat pada pasien kritis dapat berdampak positif pada pemilihan proses pengobatan, rehabilitasi yang tepat bagi pasien dan mencegah terjadinya komplikasi maupun kontraktur otot. Saran: Penelitian lebih lanjut mengenai inovasi teknologi kekuatan otot pada pasien kritis perlu dilakukan lebih mendalam karena bermanfaat dalam membantu perawat dan penyedia layanan kesehatan dalam mengukur kekuatan otot pada pasien kritis, sehingga akan bermanfaat bagi pasien kritis dan memberikan hasil pengukuran kekuatan otot yang tepat dan valid. Kata Kunci: Kekuatan Otot; Pasien Kritis; Pengukuran; Teknologi.
... Some studies have shown that NMES is superior to voluntary exercise in preventing muscle loss following a period of immobilization [13][14][15][16]. Limited evidence exists to support the effectiveness of NMES in restoring muscle mass in patients with KOA compared to conventional exercise therapy. ...
Background
One of the major contributors to disability in Knee osteoarthritis (KOA) patients is weakness in the Quadriceps Femoris muscle. Neuromuscular electrical stimulation (NMES) has been used in rehabilitation for patients suffering from muscle weakness. Thus, the purpose of the study was to assess the effectiveness of NMES and exercise therapy, for improving pain, muscle weakness and function among patients with KOA.
Methods
A randomized controlled trial was conducted with 75 female patients diagnosed with KOA. Participants were divided into three intervention groups: NMES-only, exercise therapy (Exs) alone, and a combination of NMES and exercise (NMES + Exs). All patients underwent 12 supervised treatment sessions, three times a week. Outcome measures included pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), thigh muscle girth (TG), thickness of the Vastus Medialis Oblique (VMO), timed up and go test (TUG), six-minute walk test (6MWT), and WOMAC scores. Statistical analyses (ANOVA and Kruskal–Wallis) methods were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks.
Results
The NMES group exhibited a significant reduction in pain at the 12-week follow-up compared to the other groups(p = 0.022). The NMES + Exs group showed better outcomes in terms of FROM, TG, and VMO thickness post-intervention (p < 0.0001, p < 0.004, p = 0.003, respectively) and at the 12-week follow-up (p < 0.0001, p < 0.0001, p < 0.0001, respectively). Additionally, NMES was superior in improving TUG and 6MWT post-intervention (p < 0.0001, p = 0.038, respectively) and during the follow-up assessments (p < 0.0001, p = 0.029, respectively). The NMES + Exs group achieved better WOMAC stiffness scores at both post-intervention and follow-up evaluations (p < 0.0001, p < 0.0001, respectively). Furthermore, at the 12-week follow-up, NMES + Exs group outperformed the others in WOMAC pain and function subscales (p = 0.003, p = 0.017, respectively), while the NMES group demonstrated better WOMAC total scores compared to the other groups (p = 0.007).
Conclusion
The combination of NMES and exercise seems to be an efficient approach for managing KOA, as it enhances knee flexion range and TG, increases VMO thickness, and improves WOMAC scores. On the other hand, NMES alone was found to be effective in improving the physical function of KOA patients.
Trial registration
IRCT20101228005486N7 (06–02-2020).
... It has been reported by the World Health Organization that adults should participate in 150 min/week of physical activities to maintain good health [1,2]. However, it is difficult for bedridden patients suffering from muscle atrophy, caused by long-term disuse, to fulfill this requirement [3][4][5][6][7]. This elicits a vicious cycle where the ramifications include, but are not limited to, an increased risk of cancer, cardiovascular diseases, diabetes, and sarcopenia [8,9]. ...
It is vital for rehabilitating patients to perform as many task-related exercises as possible. These patients often need either force or trajectory assistance in order to perform gait. While this can be provided in the form of traditional gait rehabilitation or currently emerging robot-assisted gait training, there is a need for an affordable means to assist gait training. In this study, we present a passive gait assistance device that is composed of a spring-bar system attached to an elastic cord and a specialized shoe. The shoe has two straps attached such that both plantar and dorsiflexion torque can be applied to the user depending on the angle of the pulling force. The merit of the devices is that it is an affordable means to provide the user with gait assistance while allowing some freedom of one’s foot movement. We show that, with 20 community-dwelling seniors, our system successfully produces plantar flexion and dorsiflexion torque according to the gait cycle. Furthermore, electromyography analysis suggests that plantar flexor demand during the late stance phase and dorsiflexor demand during the swing phase are significantly reduced.
... Entre os artigos incluídos nesta RS, sete deles (Bao et al., 2022;Cebeci et al., 2022;de Campos Biazon et al., 2021;Dirks et al., 2015;Hirose et al., 2013;Nakanishi et al., 2020;Wollersheim et al., 2019), relataram prevenção da atrofia muscular com a EENM. ...
... É concebível que os benefícios da EENM sejam relatados como resultados favoráveis na diminuição da perda de forma muscular ou ganho de massa em pacientes gravemente enfermos e/ou em coma Campos Biazon et al., 2021;Dirks et al., 2015), com complicações como sepse/choque séptico (Cebeci et al., 2022;Lago et al., 2018), COVID (Righetti et al., 2022), e traumatismo cranioencefálico (TCE) , quando internados na UTI. (Bao et al., 2022;Campos et al., 2022;Campos Biazon et al., 2021). ...
... Nos artigos onde fizeram a comparação da EENM com um grupo controle onde eram realizadas mobilização passiva/ativa ou associação da EENM com exercícios (Bao et al., 2022;Campos et al., 2022), obteve-se resultados favoráveis com a diminuição do tempo de ventilação mecânica invasiva (Santos et al., 2020), menor tempo de internação hospitalar (Campos et al., 2022), prevenção da atrofia muscular (Bao et al., 2022), até mesmo em pacientes gravemente enfermos em coma (Dirks et al., 2015). Para Hirose e colaboradores (2013), pacientes com distúrbio de consciência têm uma resposta eficaz à EENM na prevenção da atrofia muscular por desuso. ...
Analisar os efeitos da estimulação elétrica neuromuscular na perda muscular em pacientes internados em terapia intensiva. Revisão sistemática, realizada nas bases de dados Medline/Pubmed, Literatura Latino-Americana e do Caribe em Ciências da Saúde - LILACS, Scopus, Web of Science e Embase, usando os descritores: “fraqueza muscular”; “unidades de terapia intensiva”; “cuidados intensivos”; “estimulação elétrica neuromuscular”. A busca totalizou em 5.796 artigos dos quais 15 foram incluídos na revisão sistemática. Esta revisão sistemática fornece evidências de que a eletroestimulação neuromuscular associada à fisioterapia ou aplicada isolada, diferente dos cuidados habituais é mais eficaz do que os cuidados habituais isolados quando aplicada em pacientes internados em unidade de terapia intensiva.
... It will lead to muscle weakness or loss of motor function. At present, the main treatment for this symptom is neuromuscular electrical stimulation [32][33][34][35]. Its basic principle is to use the electrical excitability of nerve cells to stimulate the nerves that dominate the muscle to make the muscle contract through pulse current. ...
Along with the continuous aging of the population, various diseases have brought a great threat to human health and a large economic burden. The development of advanced medical devices has gained global attention for disease treatment. Electrical stimulation refers to stimulation and treatment of cells by high output voltage, which is an important rehabilitation and therapeutic strategy in medical treatment. Triboelectric nanogenerators (TENGs), which are lightweight and feature high-voltage output and flexible structure, have drawn great attention in the field of disease treatment for health care. The conversion of the body’s mechanical energy into electrical pulses to stimulate cells for health treatment through TENG has promising applications. Using uniquely designed TENGs to convert human mechanical energy into electrical impulses to stimulate cells is considered a promising health treatment. Here, we review the recent progress of TENG-based electrical stimulation for disease treatments, focusing on the structure, materials, and performances of the TENGs used in diverse facets of healthcare. More importantly, we systematically discuss the application of TENG-based electrical stimulation in wound healing, osteoblast proliferation and differentiation, muscle stimulation, nerve stimulation, and pacemakers. Finally, several developmental challenges of and prospective solutions for TENG-based electrical stimulation are discussed and summarized in light of recent advances.
... Neuromuscular electrical stimulation (NMES) is not a new method and is widely used in stroke rehabilitation and exercise training [8,9]. The significance of NMES in clinical application is mainly to improve the muscle strength of patients, increase the range of motion, reduce edema, reduce atrophy, reduce pain, and finally achieve the purpose of promoting tissue healing [10]. ...
Background:
This study aimed to investigate the effectiveness of neuromuscular electrical stimulation (NMES) blended with early rehabilitation on the diaphragm and skeletal muscle in sufferers on mechanical ventilation (MV).
Method:
This is a prospective randomized controlled study. Eighty patients on MV for respiratory failure were divided into a study group (40 cases) and a control group (40 cases) randomly. The study group adopted a treatment method of NMES combined with early rehabilitation and the control group adopted the method of early rehabilitation only. The diaphragmatic excursion (DE), diaphragmatic thickening fraction (DTF), variation of thickness of intercostal muscles (TIM), variation of thickness of rectus abdominis (TRA), and variation of the cross-sectional area of rectus femoris (CSA-RF) were measured to evaluate the therapeutic effect by ultrasound before and after intervention at the first day of MV, the 3rd and 7th day of intervention and the day discharged from ICU.
Results:
No significant difference was found in the general demographic information and ultrasound indicators between the two groups before treatment (all P > 0.05). After treatment, the variation of DTF (0.15 ± 0.05% vs. 0.12 ± 0.04%, P = 0.034) was significantly higher in the study group than that in the control group on the day discharged from ICU. The variation of TRA (0.05 ± 0.09% vs. 0.10 ± 0.11%, P = 0.029) and variation of CSA-RF (0.13 ± 0.07% vs. 0.19 ± 0.08%, P < 0.001) in the study group were significantly lower than that in the control group. The duration of MV in the study group was significantly shorter than that in the control group [109.5 (88.0, 213.0) hours vs. 189.5 (131.5, 343.5) hours, P = 0.023]. The study group had better muscle strength score than the control group at discharge (52.20 ± 11.70 vs. 44.10 ± 15.70, P = 0.011).
Conclusion:
NMES combined with early rehabilitation therapy is beneficial in reducing muscle atrophy and improving muscle strength in mechanically ventilated patients. This treatment approach may provide a new option for patients to choose a rehabilitation program; however, more research is needed to fully evaluate the effectiveness of this treatment option.
... Eligible studies with different designs were grouped into three categories: a) One study focused on wound-healing [8]. b) A total of 25 studies examined transepithelial EFs and their influence on cell migration, orientation, and nerve growth [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. c) Another study explored the aspect of bioelectricity that regulate cellular differentiation and diabetic arteriopathy [19]. ...
... This electrical signalling produces the electrical potential of the cell's plasma membrane at rest, called Vmem Based on this connection, the research has shown that bioelectrical signalling is vital to the healing process [31]. This healing process has been discussed in three primary sections in the foot and ankle areas: regeneration and mending of the wound [8], treatment of a damaged nervous system [14], and modification of arteriopathies through changes in the cellular proliferation or expression and pattern of genes [19]. The three main regulatory networks controlling cellular activities are chemical gradients, gene regulatory networks, and bioelectricity [4]. ...
Background: In addition to biochemical gradients and transcriptional networks, cell behaviour is controlled by endogenous bioelectrical signals resulting from the action of ion channels and pumps. Cells are regulated not only by their own membrane resting potential (Vmem) but also by the Vmem of neighbouring cells, establishing networks through electrical synapses known as gap junctions. V mem is the primary factor in producing a polarity that can regulate cell assimilation of various substances. This article aimed to examine how cell polarity can change and how variations in cell polarity may lead to clinical demonstrations.Materials and Methods: Using Cochrane Central, PubMed, Scopus, Web of Science (WOS), and Embase, a comprehensive qualitative literature review was conducted from February 1, 2018, to February 1, 2023, to identify studies addressing bioelectric, cell polarity, and electroceuticals in patients with foot and ankle problems.Results: Out of 1,281 publications, 27 were included. One study investigated bioelectric wound-healing. Twenty-five studies examined bioelectric nerve cell growth, whereas one study evaluated bioelectricity-induced cellular differentiation in the treatment of arteriopathies.Conclusion: The author of this systematic review support addressing the predisposing factors and healing impediments for a disease, thereby enhancing the healing process and reducing the likelihood of recurrence or parallel conditions. This method of treatment has provided a summary of evidence indicating that cell polarity could be addressed for the treatment and prevention of most if not all, foot and ankle problems. However, owing to the limitations of V mem and bioelectricity measurement and the direct or indirect involvement of genetics and chemical gradients, further studies are required to confirm these results.
... Likewise, recent two meta-analyses have reported that NMES did not decrease the length of ICU stay and mortality of patients with critical illness (10,11). However, after 2019, several randomized controlled trials (RCTs) have reported evidence in support of the use of NMES in the ICU (12)(13)(14)(15)(16)(17)(18)(19). As a result, a meta-analysis to determine the effect of NMES on critically ill patients is urgently required. ...
Objectives:
Neuromuscular electrical stimulation (NMES) is used in the rehabilitation of patients with critical illness. However, it is unclear whether NMES prevents ICU-acquired weakness (ICU-AW). For this purpose, we conducted an updated systematic review and meta-analysis.
Data sources:
We searched the MEDLINE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi databases from April 2019 to November 2022 to identify new randomized controlled trials to the previous meta-analysis.
Study selection:
We systematically searched the literature for all randomized controlled trials on the effect of NMES in patients with critical illness.
Data extraction:
Two authors independently selected the studies and extracted data. They calculated the pooled effect estimates associated with the occurrence of ICU-AW and adverse events as primary outcomes and muscle mass change, muscle strength, length of ICU stay, mortality, and quality of life as secondary outcomes. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Data synthesis:
Overall, eight studies were added to the previous 10 studies. Evidence suggests that the use of NMES reduces the occurrence of ICU-AW (six trials; risk ratio [RR], 0.48; 95% CI, 0.32-0.72); however, NMES may have little to no effect on pricking sensation in patients (eight trials; RR, 6.87; 95% CI, 0.84-56.50). NMES is likely to reduce the change in muscle mass (four trials; mean difference, -10.01; 95% CI, -15.54 to -4.48) and may increase muscle strength (six trials; standardized mean difference, 0.43; 95% CI, 0.19-0.68). Further, NMES may result in little to no difference in the length of ICU stay, and the evidence is uncertain about the effect on mortality and quality of life.
Conclusions:
This updated meta-analysis revealed that the use of NMES may result in a lower occurrence of ICU-AW in patients with critical illness, but its use may have little to no effect on pricking sensation in patients.
... Based on this connection, the research shows that bioelectrical signalling is vital to the healing process(36). In the foot and ankle area, this healing process has been discussed in three primary sections: Regeneration and mending of wound(8), treatment of a damaged nervous system (14), and modi cation of arteriopathies through changes in the cellular proliferation or expression and pattern of genes (19). ...
Background: In addition to biochemical gradients and transcriptional networks, the behaviour of cells is controlled by endogenous bioelectrical signals resulting from the action of ion channels and pumps. Both biochemical and transcription network modifications can have their impacts through bioelectric modifications, and bioelectric modifications by producing polarity can act as precursor patterns for future genetic evolutions and biochemical modifications.
In further details, the proliferation, differentiation, cell shape, and death of stem, progenitor, and somatic cells are governed by instructive messages mediated by variations in resting potential. Cells are regulated not only by their own Vmem (membrane resting potential) but also by the Vmem of their neighbours, establishing networks through electrical synapses known as gap junctions. Changes in the spatial and temporal distribution of Vmem in nonneuronal somatic tissues produce cell polarity which govern pattern development and act as signals that establish the polarity of the body's anatomical axis, and initiate limb regeneration. This article discusses how variations in cell polarity can induce clinical problems and how examining cell polarity might aid in symptom management.
Methods: Using Ovid-MEDLINE, Cochrane central, PubMed, Scopus, Web of Science (WOS), and Embase, a comprehensive qualitative literature review was conducted from February 1, 2018, through February 1, 2023. This evaluation includes all types and designs of studies involving the phrases bioelectric, cell polarity, electroceuticals, human, people, diseases, illnesses, and foot and ankle problems, which were connected using the conjunctions "and" and "or."
Results: From a total of 1281 publications identified, 27 were chosen. One of this research investigated bioelectric wound healing. 25 studies addressed bioelectric nerve cell growth, whereas one evaluated bioelectricity-induced cellular differentiation in the treatment of arteriopathies.
Conclusion: After analysing the data, the author recommends that cell polarity be addressed for the treatment and prevention of most, if not all, foot and ankle problems. This strategy will assist in addressing most of the predisposing factors and healing impediments for a disease, hence enhance healing process and reducing the likelihood of recurrence or parallel conditions. Due to the limits of bioelectricity measurement and the involvement of mechanical and chemical gradients, more studies are required to confirm these results.
Intracerebral hemorrhage (ICH) is a major cause of death and disability worldwide. The benefits of electrical stimulation in the treatment of respiratory dysfunction in patients on mechanical ventilation is unknown. Nevertheless, there is a dearth of evidence-based medical research concerning its clinical efficacy. From January 2019 to January 2023, every enrolled patients experienced respiratory dysfunction after ICH while being supported by mechanical ventilation. A total of 205 eligible patients were enrolled and then allocated into 2 groups: control group and observation group. 133 patients was selected and administered standard treatment as control group. Based on conventional treatment, other 72 patients were administered diaphragm electrical stimulation (DES) treatment. We examined information from current medical records, encompassing all initial data and predictive follow-up data, such as the weaning success rate, occurrence of ventilator-associated pneumonia (VAP), duration of stay in the intensive care unit (ICU) and hospital, expenses related to hospitalization, and mortality within 30 days. The baseline clinical data of the 2 groups did not exhibit any statistically significant disparities (all P > .05). The rate of successful weaning showed a significant increase in the DES group when compared to the control group (P = .025). In patients with respiratory dysfunction due to ICH, treatment with DES resulted in a significant reduction in the duration of invasive ventilation (9.8 ± 2.1 vs 11.2 ± 2.6, P < .01) and total ventilation time (9.8 ± 2.1 vs 11.2 ± 2.6, P < .01). It also led to a decrease in the length of stay in the ICU (15.67 ± 3.76 vs 17.53 ± 4.28, P = .002) and hospitalization cost (11500 vs 13600, P = .001). Additionally, DES treatment resulted in a lower incidence of VAP (73.61% vs 86.46%, P = .022) and improved 30-day mortality (P < .05), without any significant adverse effects. The findings of this research indicate that DESs have a positive impact on enhancing the rate of successful weaning and reducing the incidence of VAP. It decreases the duration of invasive ventilation and total ventilation time while also improving the mortality rate within 30 days. This therapy could offer a fresh alternative for respiratory impairment in patients undergoing mechanical ventilation.
