Effect of electrical muscle stimulation on prevention of ICU acquired muscle weakness and facilitating weaning from mechanical ventilation

Available online 19 April 2013

Peer review under responsibility of Alexandria University Faculty of Medicine.

Figures & data

Figure 1 EMS equipment.

Table 1 Functions assessed in MRCS.

Upper limb	Wrist flexion	Grade 0–5 X2 (RT&LT)
	Forearm flexion	Grade 0–5 X2 (RT&LT)
	Shoulder abduction	Grade 0–5 X2 (RT&LT)
Lower limb	Ankle dorsiflexion	Grade 0–5 X2 (RT&LT)
	Knee extension	Grade 0–5 X2 (RT&LT)
	Hip flexion	Grade 0–5 X2 (RT&LT)

Table 2 Grading of muscle strength according to MRCS.

Grade 5	Full active range of motion & normal muscle resistance
Grade 4	Full active range of motion & reduced muscle resistance
Grade 3	Full active range of motion & no muscle resistance
Grade 2	Reduced active range of motion & no muscle resistance
Grade 1	No active range of motion & palpable muscle contraction
Grade 0	No active range of motion & no palpable muscle contraction

Table 3 Baseline characteristics of patients in the EMS and control groups.

Parameters	EMS group (40 patients)	Control group (40 patients)	p
Age (years)	59.07 ± 5.32	57.57 ± 6.80	p: 0.276
Sex	Male: 24/40 (60%) Female: 16/40 (40%)	Male: 27/40 (67.5%) Female: 13/40 (32.5%)	p: 0.321
Diagnosis:^@
Type I resp. failure	7/40 (17.5%)	5/40 (12.5%)	0.53
Type II resp. failure	15/40 (37.5%)	14/40 (35%)	0.81
Type III resp. failure	13/40 (32.5%)	16/40 (40%)	0.48
Type IV resp. failure	5/40 (12.5%)	5/40 (12.5%)	–
Apache II	24.5 ± 6.8	26.1 ± 5.3	0.082

@ Yates corrected Chi squares was used to calculate the p value.

Table 4 Comparison between the two studied groups regarding MRCS at different periods of follow up.

MIRCS at	EMS group	Control group	t-value	p
Day 2
Range	32.00–58.00	38.00–60.00
Mean ± S.D	49.28 ± 6.88	50.23 ± 5.51	0.465	0.497
Day 3
Range	20.00–60.00	28.00–59.00
Mean ± S.D	45.25 ± 9.64	46.43 ± 7.21	1.781	0.094
Day 4
Range	21.00–60.00	18.00–60.00
Mean ± S.D	46.86 ± 10.88	43.70 ± 9.32	1.888	0.041^*
Day 5
Range	20.00–60.00	12.00–60.00
Mean ± S.D	45.83 ± 11.39	40.69 ± 10.48	1.998	0.044^*
Day 6
Range	22.00–60.00	12.00–58.00
Mean ± S.D	43.00 ± 12.07	39.63 ± 10.30	1.817	0.046^*
Day 7
Range	19.00–57.00	17.00–50.00
Mean ± S.D	43.37 ± 9.85	37.27 ± 13.43	1.848	0.049^*
Day 14
Range	12.00–57.00	21.00–51.00
Mean ± S.D	37.91 ± 11.14	32.89 ± 16.89	1.231	0.047^*
Day 21
Range	14.00–26.00	20.00–42.00
Mean ± S.D	29.67 ± 8.87	19.60 ± 4.34	2.009	0.037^*
Day 28
Range	14.00–29.00	19.00–42.00
Mean ± S.D	20.60 ± 5.68	21.00 ± 9.76	3.584	0.091

* Significant.

Figure 2 Comparison between the two studied groups regarding Duration of Mechanical Ventilation (DMV).

Figure 3 Comparison between the two studied groups regarding Ventilator Free Survival out of 28 days (VFS).

Table 5 Comparison between the two studied groups regarding outcome.

Outcome	Group
	EMS group		Control group		Total
	No.	%	No.	%	No.	%
Weaned	31	77.5	27	67.5	58	72.5
Died (28 days mortality)	4	10.0	6	15.0	10	12.5
Still ventilated (at 28 days)	5	12.5	7	17.5	12	15.0
Total	40	100.0	40	100.0	80	100.0
X^2		1.914
P		0.046^*

* Significant.