Author/Year

Type of study

Sample/

Characteristics

Objective

Used parameters

Main results

Evidence level

Maffiuletti et al., 2013

[19]

RCT systematic review

8 RCTs published between 2009 and 2012. ICU patients of both genders, aged between 48 and 72 years. Of the 172 patients 74 (NMES) and 76 (CG) and 22 patients received NMES on one side of the body and the contralateral one was the control.

To assess the effectiveness of NMES to prevent weakness and loss of muscle mass in critically ill patients compared to usual care.

Duration of the protocol: between 7 days and 6 weeks. MG: gluteus, quadriceps, hamstrings, fibularis long us and biceps.

F: between 8 - 100 Hz;

I: between 15 - 47 mA (evoking visible muscle contraction); T: 250 - 400 μs; Ton: between 2 - 12 s; Toff: between 4 - 24 s; TA: 25 to 60 min/day; P: symmetrical biphasic rectangular.

The NMES added to the usual physiotherapy care proved to be more effective than just the usual care to prevent ICUAW.

1A

Angelopoulos et al., 2013 [22]

Pilot randomized prospective Study

Group 1-SIRS or sepsis with diagnosis of three to five days on the day of the NMES session. Group 2-with diagnosis of ICUAW. Both sexes with average age = 59 years. Patients randomized to HF (17) and MF (14) protocol. NMES of 30 min on both LL.

To compare changes in systemic and local microcirculation during a single session of HF and MF NMES.

Single 30 min application

MG: vast lateral and medial, long fibular.

HF group = F: 75 Hz, T: 400 μs, Ton: 5 s, Toff: 21 s.

MF group = F: 45 Hz, T: 400 μs, Ton: 5 s, Toff: 12 s.

Employed HF and MF with biphasic symmetrical trapezoidal pulses.

A single NMES session produces changes in local and systemic microcirculation. The medium and high frequency currents were equally effective.

2B

Williams et al., 2013 [23]

Systematic review of randomized trials and observational prospective trials

8 studies on NMES without date limit for the research. Of these 357 ICU patients were randomized to receive NMES on one side of the body and the other served as control. And 10 patients were randomized to receive 2 treatment periods for each patient.

Investigate the evidence of the effects of NMES in severe patients.

Duration of protocol: between 4 days up to 4 weeks or discharge from ICU. MG: biceps brachii, vastus lateralis and medialis, fibularis long us, quadriceps, rectus femoris.

F: between 1.75 - 100 Hz; I: between 0 - 120 mA (evoking visible muscle contraction); T: 250 - 400 μs; Ton: between 2 - 12 s; Toff: between 4 - 24 s; TA: 30 to 60 min/day.

NMES has potential advantages in improving muscle strength, reducing MV time, and length of stay in ICU. However, the heterogeneity of the included studies shows that the evidence is inconclusive about the efficacy of NMES in critically ill patients.

2A

Wageck et al., 2014 [18]

Systematic review with meta-analysis

9 (RCT and quasi-randomized) published between 1986 and 2013. ICU patients of both sexes over 18 years of age. Of the 274 patients, 139 (CG) and 135 (IG) who received NMES in UL and LL.

To investigate the application and effects of NMES in ICU patients.

Duration of the protocol: between 7 days and 5 weeks or until extubation or discharge from ICU. MG: quadriceps, posterior thigh, vastus medial and lateral, inguinal, fibular and biceps.

F: between 1.75 - 100 Hz; I: from palpable and visible to tetanic contraction. T: 300 - 400 μs; Ton: between 2 - 12 s; Toff: between 4 - 24 s; TA: 30 to 60 min.

NMES presents positive results for the maintenance of strength and muscle mass in critically ill patients in ICU.

1A