Effect of neuromuscular electrical stimulation on the recovery of people with COVID-19 admitted to the ICU: A narrative review, Burgess et al, 2021

[Andy]

Full title: Effect of neuromuscular electrical stimulation on the recovery of people with COVID-19 admitted to the intensive care unit: A narrative review

Abstract
The rehabilitation of patients with COVID-19 after prolonged treatment in the intensive care unit is often complex and challenging. Patients may develop a myriad of long-term multi-organ impairments, affecting the respiratory, cardiac, neurological, digestive and musculoskeletal systems. Skeletal muscle dysfunction of respiratory and limb muscles, commonly referred to as intensive care unit acquired weakness, occurs in approximately 40% of all patients admitted to intensive care. The impact on mobility and return to activities of daily living is severe. Furthermore, many patients experience ongoing symptoms of fatigue, weakness and shortness of breath, in what is being described as “long COVID”. Neuromuscular electrical stimulation is a technique in which small electrical impulses are applied to skeletal muscle to cause contractions when voluntary muscle contraction is difficult or impossible. Neuromuscular electrical stimulation can prevent muscle atrophy, improve muscle strength and function, maintain blood flow and reduce oedema. This review examines the evidence, current guidelines, and proposed benefits of using neuromuscular electrical stimulation with patients admitted to the intensive care unit. Practical recommendations for using electrical muscle stimulation in patients with COVID-19 are provided, and suggestions for further research are proposed.

Lay Abstract
Many patients with COVID-19 are admitted to the intensive care unit with ongoing symptoms of fatigue, weakness and shortness of breath. Neuromuscular electrical stimulation is a technique in which small electrical impulses are applied to skeletal muscle to cause contractions when voluntary muscle contraction is difficult or impossible. It can prevent muscle atrophy, improve muscle strength and function, maintain blood flow and reduce oedema. This review examines the evidence, current guidelines, and proposed benefits of using neuro-muscular electrical stimulation with patients admitted to the intensive care unit. Practical recommendations for using electrical muscle stimulation with COVID-19 patients are provided and suggestions for further research are proposed.

Link to abstract, https://www.medicaljournals.se/jrm/content/abstract/10.2340/16501977-2805
Currently there doesn't appear to be any link to the article itself, I assume it will appear in time.

 

[Peter T]

Although I can see the rational for trying this, it is highly possible that PEM could be triggered by such electrical stimulation. So people with this symptom could end up with their condition being worsened by such intervention.

 

[alktipping]

some one seeking another cashcow

 

[Snow Leopard]

I think this is worth studying, though I don't think the authors of this review really understand the relationship between the benefits they cite "muscle atrophy, improve muscle strength and function, maintain blood flow and reduce oedema".

Cardiovascular fitness will still decline even with electrical stimulation as proposed.

 

[Creekside]

Although I can see the rational for trying this, it is highly possible that PEM could be triggered by such electrical stimulation.

I think that (testing whether PEM can be triggered by electrical muscle stimulation) would be worthwhile. There are other possibilities, such as the cognitive effort to get those muscles moving being responsible for triggering PEM. I'm pretty convinced that muscle damage, and the consequent immune response, was responsible for my triggering of PEM, but proper scientific testing is better than just assuming that a hypothesis is correct.