Combining exercise, protein supplementation and electric stimulation to mitigate muscle wasting and improve outcomes for survivors of critical illness-The ExPrES study.
Avelino C Verceles, Monica Serra, Derik Davis and 6 others
PMID 36473808WHAT IT FOUND
In mechanically ventilated older adults, combining electrical stimulation, high-protein supplementation, and extra physical therapy reduced muscle loss and improved nitrogen balance compared to standard care.
However, this multimodal bundle did not significantly shorten ICU stays or reduce ventilator days.
Key findings
01The intervention group lost significantly less thigh and lower leg muscle volume at day 14 compared to the standard care group.
02Participants receiving the combined intervention achieved positive nitrogen balance by day 5, whereas the standard care group remained in negative balance throughout the study.
03There were no statistically significant differences between the groups in ICU length of stay, ventilator days, or discharge disposition.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was a pilot with a small sample size (39 participants), leading to low statistical power. Attrition was high; many participants could not complete day 14 assessments due to early ICU discharge. The intervention was a complex bundle (extra PT + NMES + high protein), so it is impossible to determine which component caused the observed benefits. The intervention group received more physical therapy sessions than the control group, which may have confounded the muscle mass results. Blinding of participants and therapists was not feasible given the nature of the interventions.
Declared interests
The authors declare no competing interests. The study was supported by the National Institutes of Health (NIH) and the U.S. Government.
The easy way to misread this
Do not assume the electrical stimulation or protein supplementation alone caused the muscle preservation. The intervention group also received extra physical therapy sessions, and the study design cannot separate the effects of these three components.