Effect of Electrical Muscle Stimulation in Critically Ill Patients

University Health Network, Toronto30 enrolled

Overview

Electrical muscle stimulation (EMS) is the therapy used to passively activate muscles using electrodes on the surface of the skin. EMS may be helpful in preserving muscle function in people who are on bedrest due to critical illness in the intensive care unit. The purpose of this study is to determine the safety and feasibility of implementing EMS in critically ill patients who are on mechanical ventilation for greater than 7 days, and examine the effects of 4 weeks of EMS on leg muscle size, muscle strength and functional outcomes in these patients. The investigators hypothesize that EMS will be safe and feasible and that critically ill patients receiving EMS will show a smaller loss of muscle size and strength than those in the control group, who do not receive EMS.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Enrollment

Conditions

Critical Illness

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * admitted to the medical-surgical ICU or cardiovascular ICU * walking independently prior to admission * mechanically ventilated for more than 7 days (i.e. prolonged ventilation) * receiving enteral or parenteral nutrition. Exclusion Criteria: * history of neurological or psychiatric disease * primary muscle disease (e.g. muscular dystrophy, polymyositis) * catastrophic neurological event * receiving palliative care * contraindications to EMS (e.g. cardiac pacemaker/defibrillator, pregnancy, infected or cancerous lesions in proximity of electrode sites) * inadequate access to electrode sites due to medical devices * lower extremity edema affecting the thighs or buttocks * BMI \> 35 kg/m2 * allergies to adhesives or latex

Outcomes

Primary Outcomes

feasibility of EMS treatment

the number of EMS treatments that are successfully applied will be expressed as a frequency of the total number of treatments attempted

Time frame: 4 weeks

Secondary Outcomes

muscle strength

muscle strength using manual muscle testing

Time frame: baseline, 2 weeks and 4 weeks

muscle thickness

thickness of the quadriceps muscle will be assessed using muscle ultrasound

Time frame: baseline, 2 weeks, 4 weeks