title: Effect of neuromuscular stimulation and individualized rehabilitation on muscle strength in Intensive Care Unit survivors: A randomized trial.
abstract: Intensive Care Unit (ICU) survivors experience muscle weakness leading to restrictions in functional ability. Neuromuscular electrical stimulation (NMES) has been an alternative to exercise in critically ill patients. The aim of our study was to investigate its effects along with individualized rehabilitation on muscle strength of ICU survivors.
  
  
  
  Following ICU discharge, 128 patients (age: 53±16years) were randomly assigned to daily NMES sessions and individualized rehabilitation (NMES group) or to control group. Muscle strength was assessed by the Medical Research Council (MRC) score and hand grip at hospital discharge. Secondary outcomes were functional ability and hospital length of stay.
  
  
  
  MRC, handgrip, functional status and hospital length of stay did not differ at hospital discharge between groups (p>0.05). ΔMRC% one and two weeks after ICU discharge tended to be higher in NMES group, while it was significant higher in NMES group of patients with ICU-acquired weakness at two weeks (p=0.05).
  
  
  
  NMES and personalized physiotherapy in ICU survivors did not result in greater improvement of muscle strength and functional status at hospital discharge. However, in patients with ICU-aw NMES may be effective. The potential benefits of rehabilitation strategies should be explored in larger number of patients in future studies.
  
  
  
  www.Clinicaltrials.gov: NCT01717833.
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Irini
authors.initials: I
authors.lastname: Patsaki
authors.affiliation: Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, First Critical Care Department, National and Kapodistrian University of Athens, Greece. Electronic address: a.icusn@gmail.com.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Gerovasili
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Sidiras
authors.affiliation: Cardiopulmonary Exercise Testing and Rehabilitation Laboratory, First Critical Care Department, National and Kapodistrian University of Athens, Greece.
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Karatzanos
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Georgios
authors.initials: G
authors.lastname: Mitsiou
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Papadopoulos
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Christakou
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Routsi
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Kotanidou
authors.affiliation: First Critical Care Department, Evangelismos Hospital, Medical School, National and Kapodistrian University of Athens, Greece.
authors.forename: Serafim
authors.initials: S
authors.lastname: Nanas
mesh_terms: D016638:Critical Illness / Q000534:rehabilitation*; D004599:Electric Stimulation Therapy; D005260:Female; D018737:Hand Strength; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008875:Middle Aged; D018908:Muscle Weakness / Q000534:rehabilitation*; D010351:Patient Discharge; D026741:Physical Therapy Modalities; D016896:Treatment Outcome
keywords: Critical illness; Muscle strength; Neuromuscular electrical stimulation; Physiotherapy; Post-ICU rehabilitation