Neuromuscular electrical stimulation may attenuate muscle proteolysis after cardiovascular surgery: A preliminary study

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• 作者：Kotaro Iwatsu ; PhD ; PT^a ; Yuki Iida ; PhD ; PT^a ; ^b ; Yuji Kono ; PhD ; PT^c ; Takenori Yamazaki ; MD^d ; Akihiko Usui ; MD ; PhD^e ; Sumio Yamada ; PhD ; PT^c ; ^{yamadas@met.nagoya-u.ac.jp}
• 关键词：electric stimulation therapy ; skeletal muscle ; proteolysis ; muscle weakness ; cardiovascular surgical procedures ; rehabilitation
• 刊名：The Journal of Thoracic and Cardiovascular Surgery
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：153
• 期：2
• 页码：373-379.e1
• 全文大小：1243 K
• 卷排序：153

文摘

To explore the efficacy of postoperative neuromuscular electrical stimulation (NMES) on muscle protein degradation and muscle weakness in patients after cardiovascular surgery.MethodsSixty-one patients underwent NMES daily from postoperative days (PODs) 1 to 5 in addition to postoperative mobilization program (NMES group), and 41 patients underwent postoperative mobilization program only (non-NMES group). The primary outcome was the concentration of 3-methylhistidine (3-MH) in 24-hour urine corrected for urinary creatinine content (3-MH/Cre) from PODs 1 to 5. The secondary outcomes were knee extensor isometric strength (KEIS) and handgrip strength at POD 7.ResultsBaseline characteristics such as age, sex, preoperative body mass index, hemoglobin, handgrip strength, KEIS, surgery type, cardiopulmonary bypass time, and immediate postoperative interleukin-6 were not different between the groups. Urinary 3-MH/Cre was increased significantly in both groups; however, urinary 3-MH/Cre in the NMES group peaked earlier compared with that in the non-NMES group. KEIS at POD 7 was significantly greater in the NMES group (median [interquartile range], 0.40 kg/weight [0.33-0.45] in the NMES group vs 0.23 kg/weight [0.15-0.36] in the non-NMES group; P < .01). Handgrip strength at POD 7 was also significantly greater in the NMES group (median [interquartile range], 32 kg [24.5-35.3] in the NMES group vs 24 kg [16.0-30.0] in the non-NMES group; P < .01).ConclusionsThis study demonstrated that NMES might attenuate skeletal muscle protein degradation and muscle weakness after cardiovascular surgery. A cause-effect relationship between NMES and functional preservation would be a future challenging issue.