title: Effects of neuromuscular electrical stimulation on muscle layer thickness of knee extensor muscles in intensive care unit patients: a pilot study.
abstract: OBJECTIVE
  It is known that patients in the intensive care unit show an enormous loss of muscle mass. Neuromuscular electrical stimulation is effective in enhancing strength and endurance in immobilized patients. The aim of this study was to evaluate the effects of neuromuscular electrical stimulation on muscle layer thickness of knee extensor muscles in intensive care unit patients.
  
  
  METHODS
  Randomized, controlled, double-blind, pilot trial.
  
  
  METHODS
  Thirty-three patients, male to female ratio 26:7, mean age 55 years (standard deviation 15).
  
  
  METHODS
  After enrolment in the study, intensive care unit patients (main diagnoses: polytrauma, cardiovascular diseases, transplantation, pneumonia, cancer) were stratified (based on the length of their stay in hospital) into 2 groups: 17 acute patients (< 7 days) and 16 long-term patients (> 14 days). Both groups were randomized to a stimulation group or a sham-stimulation group. Neuromuscular electrical stimulation was applied to knee extensor muscles for a period of 4 weeks (session time 30-60 minutes, 5 days/week). Ultrasound measurements were performed before and after the stimulation period to quantify muscle layer thickness of knee extensor muscles.
  
  
  RESULTS
  Only stimulated long-term patients (+4.9%) showed a significant (p = 0.013) increase in muscle layer thickness compared with sham-stimulated patients (-3.2%).
  
  
  CONCLUSIONS
  Neuromuscular electrical stimulation appears to be a useful adjunct to revert muscle wasting in intensive care unit long-term patients; however, larger studies with a larger sample size are needed to confirm these promising, but preliminary, results.
authors.affiliation: Joint and Bone Center (Center for Diagnosis, Research and Therapy of Musculoskeletal Disorders), Medical University of Vienna, Vienna, Austria. wolfgang.gruther@meduniwien.ac.at
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Gruther
authors.forename: Franz
authors.initials: F
authors.lastname: Kainberger
authors.forename: Veronika
authors.initials: V
authors.lastname: Fialka-Moser
authors.forename: Tatjana
authors.initials: T
authors.lastname: Paternostro-Sluga
authors.forename: Michael
authors.initials: M
authors.lastname: Quittan
authors.forename: Christian
authors.initials: C
authors.lastname: Spiss
authors.forename: Richard
authors.initials: R
authors.lastname: Crevenna
mesh_terms: D000328:Adult; D000368:Aged; D003422:Critical Care; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007717:Knee / Q000502:physiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000473:pathology*; D009133:Muscular Atrophy / Q000517:prevention & control / Q000628:therapy*; D010865:Pilot Projects; D016896:Treatment Outcome; D014463:Ultrasonography