The purposes of this study are 1) to determine whether neuromuscular electrical stimulation (NMES) is effective in preventing loss of muscle mass and strength and 2) to observe the time variation of MLT and strength from preoperative day to hospital discharge.
In the amendment of June 2011, a twofold study setting was defined in order to recruit patients not only before, but also after cardiothoracic surgery. In sample A, patients were recruited before surgery. In sample B, patients were recruited after surgery. On postoperative day 1, randomization was performed for sample A and B separately. To ensure balance of the NMES and control groups with respect to disease severity, randomization was stratified by the SAPS II score on the first postoperative day. In the intervention group, the anterior muscles of both thighs were electrically stimulated from the first postoperative day until ICU discharge for a maximum of 14 days. In the control group, the electrodes were applied, but no electricity was delivered.The primary outcomes muscle layer thickness (MLT) and muscle strength were assessed from the first postoperative day to ICU discharge and at hospital discharge. All patients in sample A had an additional assessment of MLT and strength before surgery. All data are analyzed according to the intention-to-treat principle with no imputation for any missing data. Linear mixed models are used to account for the repeated measurements per patient and to determine any fixed effects on MLT and MRC score.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
no electricity applied
Muscle layer thickness (MLT)
Muscle layer thickness of the anterior muscles of the thigh using two-dimensional B-mode ultrasound
Time frame: on preoperative day, from postoperative day 1 onwards every other ICU day for the duration of the ICU stay (expected average of ICU stay: 7 days) and at day of hospital discharge (expected average of hospital stay: 20 days)
Muscle strength
Muscle strength using Medical Research Council (MRC) score and hand dynamometry
Time frame: on preoperative day, from postoperative day 1 onwards every day for the duration of the ICU stay (expected average of ICU stay: 7 days), at day of hospital discharge (expected average of hospital stay: 20 days)
JAGS score
JAGS score
Time frame: on preoperative day, on day of ICU discharge (expected average of ICU stay: 7 days), on day of hospital discharge (expected average of hospital stay: 20 days)
Timed Up and Go test
Timed Get Up and Go test
Time frame: on preoperative day, on day of hospital discharge (expected average of hospital stay: 20 days)
FIM score
Functional Independance Measure (FIM) score
Time frame: on preoperative day, on day of hospital discharge (expected average of hospital stay: 20 days)
SF-12 score
12-item Short Form Health Survey (SF-12)
Time frame: on preoperative day, on day of hospital discharge (expected average of hospital stay: 20 days)
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