Article

Electrical muscle stimulation (EMS) is applied to critically ill
patients in order to improve their muscle strength, thereby preventing hypotrophy
and promoting functional recovery. OBJECTIVE: To assess the effects of early EMS
on the range of movement of the ankle joint, and on thigh and leg circumference
in critically ill patients. METHODS: This is a prospective randomized clinical
trial comprising 11 patients undergoing mechanical ventilation. Before and after
EMS the thigh and leg circumference in both lower limbs and the goniometry of the
tibiotarsal joint were measured. The angle of 90 degrees on the goniometer was
taken as the standard neutral position (NP), with the arm fixed on the lateral
malleolus of the ankle joint. Other measurements, namely dorsiflexion and plantar
flexion, referred to as mobile arm, were taken from the NP. These recordings were
obtained following an active contraction of the patients' muscles. RESULTS:
Compared with the electrostimulated limb, a difference in dorsiflexion of the
control limb was observed (96.2 +/- 24.9 versus 119.9 +/- 14.1 degrees ; p =
0.01). A girth of 10 cm of the leg was found in limb reduction when compared to
the electrostimulated one (24.7 +/- 3.1 versus 26.4 +/- 4.0 cm; p = 0.03).
CONCLUSIONS: EMS used at low current intensity and for a short duration failed to
prevent muscle atrophy in critically ill patients. However, we did find a
significant improvement in active dorsiflexion of the ankle joint suggesting that
it could help to prevent against stance plantar flexion in these patients.

Langue : ANGLAIS