Effect of Perioperative Neuromuscular Electrical Stimulation in Patients Undergoing Cardiovascular Surgery: A Pilot Randomized Controlled Trial

Semin Thorac Cardiovasc Surg. 2019 Autumn;31(3):361-367. doi: 10.1053/j.semtcvs.2018.10.019. Epub 2018 Nov 2.

Abstract

A randomized, controlled trial was conducted to examine the effects of perioperative neuromuscular electrical stimulation on muscle proteolysis and physical function using blinded assessment of physical function. Consecutive patients undergoing cardiovascular surgery were screened for eligibility as study subjects. Participants were randomly assigned to receive either neuromuscular electrical stimulation or the usual postoperative mobilization program. The intervention group received neuromuscular electrical stimulation on bilateral legs 8 times before and after surgery. The primary outcomes were the mean 3-methylhistidine concentration corrected for urinary creatinine content from baseline to postoperative day 6, and knee extensor isometric muscle strength on postoperative day 7. Secondary outcomes were usual walking speed and grip strength. Physical therapists blinded to patient allocation performed measurements of physical function. Of 498 consecutive patients screened for eligibility, 119 participants (intervention group, n = 60; control group, n = 59) were enrolled. In the overall subjects, there were no differences in any outcomes between the intervention and control groups. The results demonstrated no significant effects of neuromuscular electrical stimulation on muscle proteolysis and physical function after cardiovascular surgery, suggesting the need to explore indications for neuromuscular electrical stimulation and to clarify the effects in terms of the dose-response relationship.

Keywords: Cardiovascular surgery; Neuromuscular electrical stimulation; Proteolysis.

Publication types

  • Randomized Controlled Trial
  • Video-Audio Media

MeSH terms

  • Aged
  • Cardiac Surgical Procedures* / adverse effects
  • Electric Stimulation Therapy* / adverse effects
  • Female
  • Humans
  • Japan
  • Lower Extremity
  • Male
  • Middle Aged
  • Muscle Contraction
  • Muscle Strength
  • Muscle, Skeletal / innervation*
  • Muscle, Skeletal / metabolism
  • Muscular Diseases / diagnosis
  • Muscular Diseases / metabolism
  • Muscular Diseases / physiopathology
  • Muscular Diseases / prevention & control*
  • Perioperative Care / adverse effects
  • Perioperative Care / methods*
  • Pilot Projects
  • Proteolysis
  • Recovery of Function
  • Time Factors
  • Treatment Outcome
  • Vascular Surgical Procedures* / adverse effects
  • Walking Speed