The possibility of using skeletal muscle electrical stimulation in the rehabilitation of patients after cardiac surgery
https://doi.org/10.17802/2306-1278-2019-8-4S-70-81
Abstract
Aim. To evaluate the effectiveness of electrical muscle stimulation (EMS) in patients with the complicated early postoperative period after cardiac surgery.
Methods. 61 patients (44 men and 17 women) aged 52-70 years with the complicated early postoperative period after cardiac surgery were included in the study. The complications included prolonged length of stay in the intensive care unit and prolonged mechanical ventilation. The initial muscle performance of the lower extremities was measured with the carpal and isokinetic dynamometer in all patients. The six-minute walk test was performed in all patients after they had been transferred to the department of cardiac surgery.
Results. Patients in the study group had reduced lower extremity muscle strength at baseline, compared with the control group. After the EMS sessions, the study group patients demonstrated pronounced improvements in muscle performance as compared to the control group. Both knee-joint extension values increased during the isometric contraction as compared to those in the control group (38.8% and 40.0% versus 8.1% and 8.4%, p <0.001), similarly to right knee-joint flexion (23.7% versus 10.1%, p = 0.008), left ankle joint (18.6 versus 4.3%, p = 0.010), right-hand grip strength (18.3 versus 11.1%, p = 0.042). In addition, the six-minute walk test results improved in the EMS group (119.72% (293 meters) and 87.13% (315 meters)) as compared to the control group (p = 0.079).
Conclusion. The EMS sessions did not affect the clinical status of cardiac surgical patients with the complicated postoperative period. Moreover, it appeared to be beneficial in terms of the improved lower extremity muscle strength that was more pronounced in the study group than in the control group. Therefore, the effects of EMS on the clinical status of these patients require the further investigation.
About the Authors
A. N. SuminRussian Federation
Sumin Alexei N. - M.D., Ph.D., the Head of the Department for Polyvascular and Multivessel Disease, Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”
650002, Kemerovo, 6, Sosnoviy Blvd.
phone +7 (3842) 64-44-61
P. A. Oleynik
Russian Federation
650002, Kemerovo, 6, Sosnoviy Blvd.
A. V. Bezdenejnykh
Russian Federation
650002, Kemerovo, 6, Sosnoviy Blvd.
References
1. Barbarash L.S., Sumin A.N., Bezdenezhnykh A.V., Zhuchkova E.A., Barbarash O.L. Prevalence of polyvascular disease in patients with ischemic heart disease. Complex Issues of Cardiovascular Diseases. 2013; (3): 4-11. (In Russian) doi.org/10.17802/2306-1278-2013-3-4-11
2. Barbarash O.L., Zhidkova I.I., Shibanova I.A., Ivanov S.V., Sumin A.N., Samorodskaya I.V., Barbarash L.S. The impact of comorbidities and age on the nosocomial outcomes of patients undergoing coronary artery bypass grafting. Cardiovascular Therapy and Prevention. 2019; 18 (2): 58-64. (In Russian) doi.org/10.15829/1728-8800-2019-2-58-64
3. van Venrooij L.M., Verberne H.J., de Vos R., BorgmeijerHoelen M.M., van Leeuwen P.A., de Mol B.A. Postoperative loss of skeletal muscle mass, complications and quality of life in patients undergoing cardiac surgery. Nutrition. 2012; 28 (1): 40-5. doi: 10.1016/j.nut.2011.02.007.
4. Iida Y., Yamazaki T., Kawabe T., Usui A., Yamada S. Postoperative muscle proteolysis affects systemic muscle weakness in patients undergoing cardiac surgery. Int J Cardiol. 2014 1; 172 (3): 595-7. doi: 10.1016/j.ijcard.2014.01.062.
5. Iida Y., Yamazaki T., Arima H., Kawabe T., Yamada S. Predictors of surgery-induced muscle proteolysis in patients undergoing cardiac surgery. J Cardiol. 2016; 68 (6): 536-541. doi: 10.1016/j.jjcc.2015.11.011.
6. Zuckerman J., Ades M., Mullie L., Trnkus A., Morin J.F., Langlois Y., Ma F., Levental M., Morais J.A., Afilalo J. Psoas muscle area and length of stay in older adults undergoing cardiac operations. Ann Thorac Surg. 2017; 103 (5): 14981504. doi: 10.1016/j.athoracsur.2016.09.005.
7. Yamashita M., Kamiya K., Matsunaga A., Kitamura T., Hamazaki N., Matsuzawa R., Nozaki K., Tanaka S., Nakamura T., Maekawa E., Masuda T., Ako J., Miyaji K. Prognostic value of psoas muscle area and density in patients who undergo cardiovascular surgery. Can J Cardiol. 2017; 33 (12): 16521659. doi: 10.1016/j.cjca.2017.10.009.
8. Reid J.C., Unger J., McCaskell D., Childerhose L., Zorko D.J., Kho M.E. Physical rehabilitation interventions in the intensive care unit: a scoping review of 117 studies. J Intensive Care. 2018 7; 6:80. doi: 10.1186/s40560-018-0349-x.
9. Trethewey S.P., Brown N., Gao F., Turner A.M. Interventions for the management and prevention of sarcopenia in the critically ill: A systematic review. J Crit Care. 2019; 50:287-295. doi: 10.1016/j.jcrc.2019.01.008.
10. Sumin A.N. Physical training with the use of electrostimulation of skeletal muscles in cardiology. Cardiology. 2010. Т. 50. № 3. С. 83-90. (In Russian)
11. Gomes Neto M., Oliveira F.A., Reis H.F., de Sousa Rodrigues- E. Jr, Bittencourt H.S., Oliveira Carvalho V. Effects of neuromuscular electrical stimulation on physiologic and functional measurements in patients with heart failure: a systematic review with meta-analysis. JCardiopulm Rehabil Prev. 2016; 36 (3): 157-66. doi: 10.1097/HCR.0000000000000151.
12. Saitoh M., Dos Santos M.R., Anker M., Anker S.D., von Haehling S., Springer J. Neuromuscular electrical stimulation for muscle wasting in heart failure patients. Int J Cardiol. 2016 15; 225:200-205. doi: 10.1016/j.ijcard.2016.09.127.
13. Maddocks M., Nolan C.M., Man W.D., Polkey M.I., Hart N., Gao W., Rafferty G.F., Moxham J., Higginson I.J. Neuromuscular electrical stimulation to improve exercise capacity in patients with severe COPD: a randomised double-blind, placebo-controlled trial. Lancet Respir Med. 2016; 4 (1): 27-36. doi: 10.1016/S2213-2600(15)00503-2.
14. Suzuki T., Ikeda M., Minami M., Matayoshi Y., Nakao M., Nakamura T., Abo M. Beneficial effect of intradialytic electrical muscle stimulation in hemodialysis patients: a randomized controlled trial. Artif Organs. 2018; 42 (9): 899-910. doi: 10.1111/aor.13161.
15. Paillard T. Muscle plasticity of aged subjects in response to electrical stimulation training and inversion and/or limitation of the sarcopenic process. Ageing Res Rev. 2018; 46:1-13. doi: 10.1016/j.arr.2018.05.002.
16. Iwatsu K., Yamada S., Iida Y., Sampei H., Kobayashi K., Kainuma M., Usui A. Feasibility of neuromuscular electrical stimulation immediately after cardiovascular surgery. Arch Phys Med Rehabil. 2015; 96 (1): 63-8. doi: 10.1016/j.apmr.2014.08.012.
17. Iwatsu K., Iida Y., Kono Y., Yamazaki T., Usui A., Yamada S. Neuromuscular electrical stimulation may attenuate muscle proteolysis after cardiovascular surgery: a preliminary study. J Thorac Cardiovasc Surg. 2017; 153 (2): 373-379.e1. doi: 10.1016/j.jtcvs.2016.09.036.
18. Sachetti A., Carpes M.F., Dias A.S., Sbruzzi G. Safety of neuromuscular electrical stimulation among critically ill patients: systematic review. Rev Bras Ter Intensiva. 2018; 30 (2): 219-225. doi: 10.5935/0103-507X.20180036.
19. Rodriguez P.O., Setten M., Maskin L.P., Bonelli I., Vidomlansky S.R., Attie S., Frosiani S.L., Kozima S., Valentini R. Muscle weakness in septic patients requiring mechanical ventilation: protective effect of transcutaneous neuromuscular electrical stimulation. J Crit Care. 2012; 27 (3): 319.e1-8. doi: 10.1016/j.jcrc.2011.04.010.
20. Abu-Khaber H.A., Abouelela A.M., Abdelkarim E.M. Effect of electrical muscle stimulation on prevention of ICU acquired muscle weakness and facilitating weaning from mechanical ventilation. Alexandria J Med. 2013; 49 (4): 309-15.
21. Medrinal C., Combret Y., Prieur G., Robledo Quesada A., Bonnevie T., Gravier F.E., Dupuis Lozeron E., Frenoy E., Contal O., Lamia B. Comparison of exercise intensity during four early rehabilitation techniques in sedated and ventilated patients in ICU: a randomised cross-over trial. Crit Care. 2018 27; 22 (1): 110. doi: 10.1186/s13054-018-2030-0.
22. Stefanou C., Karatzanos E., Mitsiou G., Psarra K., Angelopoulos E., Dimopoulos S., et al. Neuromuscular electrical stimulation acutely mobilizes endothelial progenitor cells in critically ill patients with sepsis. Ann Intensive Care. 2016; 6 (1): 21.
23. Leite M.A., Osaku E.F., Albert J., Costa C.R.L.M., Garcia A.M., Czapiesvski F.d.N., Ogasawara S.M., Bertolini G.R.F., Jorge A.C., Duarte P.A.D. Effects of neuromuscular electrical stimulation of the quadriceps and diaphragm in critically ill patients: a pilot study. Crit Care Res Pract. 2018; 2018: 4298583. doi: 10.1155/2018/4298583. eCollection 2018.
24. Chen S., Jiang Y., Yu B., Dai Y., Mi Y., Tan Y., Yao J., Tian Y. Effect of transcutaneous neuromuscular electrical stimulation on prevention of intensive care unit-acquired weakness in chronic obstructive pulmonary disease patients with mechanical ventilation. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2019; 31 (6): 709-713. doi: 10.3760/cma.j.issn.2095-4352.2019.06.010.
25. Kho M.E., Truong A.D., Zanni J.M., Ciesla N.D., Brower R.G., Palmer J.B., Needham D.M. Neuromuscular electrical stimulation in mechanically ventilated patients: a randomized, sham-controlled pilot trial with blinded outcome assessment. J Crit Care 2015; 30 (1): 32e9. doi.org/10.1016/j.jcrc.2014.09.014.
26. Fossat G., Baudin F., Courtes L., Bobet S., Dupont A., Bretagnol A., Benzekri-Lefèvre D., Kamel T., Muller G., Bercault N., Barbier F., Runge I., Nay M.A., Skarzynski M., Mathonnet A., Boulain T. Effect of in-bed leg cycling and electrical stimulation of the quadriceps on global muscle strength in critically ill adults: a randomized clinical trial. JAMA. 2018 24; 320 (4): 368-378. doi: 10.1001/jama.2018.9592.
27. Fischer A., Spiegl M., Altmann K., Winkler A., Salamon A., Themessl-Huber M., Mouhieddine M., Strasser E.M., Schiferer A., Paternostro-Sluga T., Hiesmayr M. Muscle mass, strength and functional outcomes in critically ill patients after cardiothoracic surgery: does neuromuscular electrical stimulation help? The catastim 2 randomized controlled trial. Crit Care. 2016 29; 20: 30. doi: 10.1186/s13054-016-1199-3.
28. Montisci A., Miceli A. A new weapon in the fight against postcardiac surgery muscle catabolism. J Thorac Cardiovasc Surg. 2017; 153 (2): 379-380. doi: 10.1016/j.jtcvs.2016.11.013
29. Mourtzakis M., Parry S., Connolly B., Puthucheary Z. Skeletal muscle ultrasound in Critical care:a tool in need of translation. Ann Am Thorac Soc. 2017; 14 (10): 1495-1503. doi: 10.1513/AnnalsATS.201612-967PS.
30.
Review
For citations:
Sumin A.N., Oleynik P.A., Bezdenejnykh A.V. The possibility of using skeletal muscle electrical stimulation in the rehabilitation of patients after cardiac surgery. Complex Issues of Cardiovascular Diseases. 2019;8(4S):70-81. (In Russ.) https://doi.org/10.17802/2306-1278-2019-8-4S-70-81