Segers et al., 2014 [13]

Cohort prospective study

50 patients of both sexes and with more than 18 years hospitalized in ICU between 3 to 5 days. NMES in both LL.

To investigate the safety and viability of NMES in critically ill patients.

Application of 25 min and 5×/week. MG: quadriceps of the thigh. 5 min heating and after protocol = F: 50 Hz, I: 0 - 80 mA, T: 300 - 500 μs, Ton: 8 s. Toff: 20 s. The intensity and pulse were adjusted until a visible or palpable contraction was obtained.

NMES is a safe intervention to be administered at the ICU. Patients with sepsis, edema and vasopressors use present less adequate contraction.

Kho et al., 2015 [24]

Randomized pilot clinical trial with blinded-results evaluation

34 patients of both sexes and with average age of 55 years. Recruited in three ICUs between 6/2008 and 3/2013 who were in MV within the first week of ICU stay and who could make independent transfer from the bed to the chair before hospital admission. Randomized 16 patients for NMESG and 18 for SIG.

To evaluate whether patients in MV who receive NMES and habitual rehabilitation versus simulated NMES intervention and habitual rehabilitation present higher strength of LL at hospital discharge.

Duration of the protocol: up to 45 days. NMESG = 60 min/day bilaterally in the quadriceps of the thigh, anterior tibial and gastrocnemius. Used pulsed current, balanced, asymmetrical and biphasic rectangular wave with 2 s ramp and ramp inactivity < 1 s and 50 Hz. Quadriceps protocol = T: 400 μs, Ton: 5 s and Toff: 10 s. Anterior and gastrocnemius tibial protocol = T: 250 μs, Ton: 5 s and Toff: 5 s. The intensity was gradually increased until a visible contraction was achieved.

SIG = current amplitude 0 mA.

NMES in critically ill patients and in MV did not significantly improve leg strength at hospital discharge.

Stefanou et al., 2016 [25]

Randomized prospective trial

32 patients, of both sexes, with mean age of 58 years with MV and sepsis admitted to ICU. They were randomized to two protocols of NMES in LL, one group of AF and another MF. Blood samples were analyzed by flow cytometry before and after application of the protocol.

To explore the role of NMES in the mobilization of ESC in hospitalized ICU patients in MV and sepsis.

The sessions took an average of 7.6 days. Application of 30 min + 10 min warm-up and recovery.

MG: vastus lateral, medial and fibular long bilaterally. Both protocols used symmetrical biphasic trapezoidal pulses. T: 400 μs, ramp up 1.5 s and descent of 0.8 s. AF = F: 75 Hz, Ton: 6 s and Toff 21 s. MF = F: 45 Hz, Ton: 5 s and Toff 12 s. The intensity was gradually increased until reaching total contraction.

NMES of MF and HF has the potential to mobilize ESC in patients with MV and sepsis admitted to ICU.