title: Effects of neuromuscular electrical stimulation on cytokines in peripheral blood for healthy participants: a prospective, single-blinded Study.
abstract: BACKGROUND
  The effect of exercise on cytokines may improve muscle strength. Neuromuscular electrical stimulation (NMES) is a muscle-preserving therapy that benefits patients unable to participate in active exercise. How NMES alters cytokines is unclear. The aim of this study was to study the effects of 1 NMES session on cytokines associated with protein metabolism during exercise.
  
  
  METHODS
  We evaluated the effects of NMES on IL-1, IL-6, IL-10 and TNF-α levels in peripheral blood. Participants received NMES to bilateral lower extremity muscles (quadriceps, tibialis anterior, gastrocnemius) for 30 min. Blood samples immediately pre- and post-NMES were drawn at 15-min intervals to 2-h follow-up, and the mean values of pre-NMES levels were compared to peak and trough post-NMES levels. For cytokines with significant changes, we conducted a repeated-measures linear regression analysis. We also measured post-NMES lactate and creatine kinase levels.
  
  
  RESULTS
  We enrolled nine eligible participants. There was a significant increase in peak IL-6 from the mean pre-NMES value [0·65 (0·89) to 1·04 (0·89) pg ml-1, P = 0·001] and a significant decrease in trough IL-1 [0·08 (0·07) to 0·02 (0·02) pg ml-1, P = 0·041] and TNF-α [2·42 (0·54) to 2·16 (0·59) pg ml-1, P = 0·021]. In repeated-measures regression analysis, we identified significantly higher mean IL-6 values throughout the full 120 min post-NMES period, and a significantly higher mean IL-1 value at 30 min post-NMES. There were no significant differences in peak IL-10, trough IL-6, lactate, or creatine kinase values.
  
  
  CONCLUSIONS
  In nine healthy humans, 30 min of NMES was temporally associated with changes in cytokines similar to the effects of active exercise and may mediate NMES' observed effects on reducing muscle weakness.
authors.affiliation: Pulmonary, Allergy and Critical Care Medicine, Emory University, Atlanta, GA, USA.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Truong
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.|School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada.
authors.forename: Michelle E
authors.initials: ME
authors.lastname: Kho
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Roy G
authors.initials: RG
authors.lastname: Brower
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Dorianne R
authors.initials: DR
authors.lastname: Feldman
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Colantuoni
authors.affiliation: Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA.|Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA.|Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Dale M
authors.initials: DM
authors.lastname: Needham
mesh_terms: D000328:Adult; D016207:Cytokines / Q000097:blood*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009119:Muscle Contraction; D053580:Muscle Strength; D009469:Neuromuscular Junction / Q000502:physiology*; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000294:innervation*; D016037:Single-Blind Method; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D016207:Cytokines; C508609:IL10 protein, human; C508600:IL6 protein, human; D007375:Interleukin-1; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10
keywords: cytokines; healthy adults; neuromuscular electrical stimulation; neuromuscular electrostimulation; weakness