Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery: A randomized controlled trial

Alexey Nikolaevich Sumin, Pavel Alexandrovich Oleinik, Andrey Viktorovich Bezdenezhnykh, Anna Valeryvena Ivanova, Alexey Nikolaevich Sumin, Pavel Alexandrovich Oleinik, Andrey Viktorovich Bezdenezhnykh, Anna Valeryvena Ivanova

Abstract

Background: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) in early rehabilitation of patients with postoperative complications after cardiovascular surgery.

Methods: 37 patients (25 men and 12 women) aged 45 to 70 years with postoperative complications after cardiovascular surgery were included in the study. Eighteen patients underwent NMES daily since postoperative day 3 until discharge in addition to standard rehabilitation program (NMES group), and 19 patients underwent standard rehabilitation program only (non-NMES group). The primary outcome was the knee extensors strength at discharge in NMES group and in control. Secondary outcomes were the handgrip strength, knee flexor strength, and cross-sectional area (CSA) of the quadriceps femoris in groups at discharge.

Results: Baseline characteristics were not different between the groups. Knee extensors strength at discharge was significantly higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45 [22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1] and 22.5 [20.1; 25.9] kg, respectively; P < .001). Handgrip strength, knee flexor strength, quadriceps CSA, and 6 minute walk distance at discharge in the groups had no significant difference.

Conclusions: This pilot study shows a beneficial effect of NMES on muscle strength in patients with complications after cardiovascular surgery. The use of NMES showed no effect on strength of non-stimulated muscle, quadriceps CSA, and distance of 6-minute walk test at discharge.Further blind randomized controlled trials should be performed with emphasis on the effectiveness of NEMS in increasing muscle strength and structure in these patients.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of study participants; NMES = neuromuscular electrical stimulation.
Figure 2
Figure 2
Knee extensor strength at POD 3 and discharge in NMES (n = 18) and control (n = 19) groups. ∗Between Baseline and Discharge in the Group; ∗∗Between Groups in Baseline or in Discharge. NMES = neuromuscular electrical stimulation, POD = postoperative day.
Figure 3
Figure 3
Knee flexor strength at POD 3 and discharge in NMES (n = 18) and control (n = 19) groups. ∗Between Baseline and Discharge in the Group; ∗∗Between Groups in Baseline or in Discharge. NMES = neuromuscular electrical stimulation, POD = postoperative day.
Figure 4
Figure 4
Handgrip strength at POD 3 and discharge in NMES (n = 18) and control (n = 19) groups. ∗Between Baseline and Discharge in the Group; ∗∗Between Groups in Baseline or in Discharge. NMES = neuromuscular electrical stimulation, POD = postoperative day.
Figure 5
Figure 5
Quadriceps muscle cross-sectional area at POD 3 and discharge in NMES (n = 18) and control (n = 19) groups. ∗Between Baseline and Discharge in the Group; ∗∗Between Groups in Baseline or in Discharge. NMES = neuromuscular electrical stimulation, POD = postoperative day.

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