Intervention effect of neuromuscular electrical stimulation on ICU acquired weakness: A meta-analysis.
Miao Liu, Jian Luo, Jun Zhou and 1 others
PMID 32685621WHAT IT FOUND
In ventilated ICU patients, neuromuscular electrical stimulation plus routine treatment and nursing care improved muscle strength, shortened ventilation and hospital stay, and increased walking distance, but did not reduce mortality or improve functional independence.
Key findings
01NMES added to routine treatment and nursing care improved muscle strength measured by the MRC score (mean difference 1.78, 95% CI 0.44 to 3.12, P = 0.009).
02NMES added to routine treatment and nursing care shortened mechanical ventilation time (standardized mean difference -0.65, 95% CI -1.03 to -0.27, P < 0.001).
03Mortality did not differ between NMES added to routine treatment and nursing care and control (risk ratio 1.07, 95% CI 0.62 to 1.84, P = 0.80).
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The included trials differed in patient groups, muscles stimulated, session length, frequency and control condition. Only two of the eleven trials were rated low risk of bias; nine were rated moderate risk. Some outcomes showed heterogeneity, and the authors could not fully explain it. The small number of studies meant publication bias could not be completely excluded. Only Chinese and English articles were searched, and gray literature and articles in other languages were not included. Adverse effects and cost-effectiveness were not assessed. Muscle thickness and area were not pooled because measurement sites differed. Functional independence, consciousness and mortality were not significantly improved.
Declared interests
This work was supported by the Chinese Nursing Association research program [ZHKY201611]. The authors declared no competing interests.
The easy way to misread this
Do not conclude that NMES alone prevents ICU-AW or improves survival. It was tested as an addition to routine treatment and nursing care, and mortality, functional independence and consciousness were not significantly improved. Adverse effects were not assessed.