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

Burgess, LC, Venugopalan, L, Badger, J, Street, T, Alon, G, Jarvis, JC, Wainwright, TW, Everington, T, Taylor, P and Swain, ID (2021) Effect of neuromuscular electrical stimulation on the recovery of people with COVID-19 admitted to the intensive care unit: A narrative review. Journal of Rehabilitation Medicine, 53 (3). ISSN 1650-1977

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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. Evidence suggests NMES may play a role in the weaning of patients from ventilators and can be continued in the post-acute and longer-term phases of recovery. As such, NMES may be a suitable treatment modality to implement within rehabilitation pathways for COVID-19, with consideration of the practical and safety issues highlighted within this review.

Item Type: Article
Uncontrolled Keywords: Science & Technology; Life Sciences & Biomedicine; Rehabilitation; Sport Sciences; critical care; rehabilitation; neuromuscular elec-trical stimulation; muscular atrophy; coronavirus infection; COVID-19; CRITICALLY-ILL PATIENTS; DEEP VENOUS THROMBOSIS; MUSCLE STIMULATION; ACQUIRED WEAKNESS; VEIN-THROMBOSIS; THROMBOEMBOLISM; PREVENTION; LEG; SURVIVORS; RISK; Humans; Hospitalization; Electric Stimulation Therapy; Intensive Care Units; Clinical Trials as Topic; Randomized Controlled Trials as Topic; COVID-19; SARS-CoV-2; COVID-19; coronavirus infection; critical care; muscular atrophy; neuromuscular electrical stimulation; rehabilitation; COVID-19; Clinical Trials as Topic; Electric Stimulation Therapy; Hospitalization; Humans; Intensive Care Units; Randomized Controlled Trials as Topic; SARS-CoV-2; Rehabilitation; 1103 Clinical Sciences; 1106 Human Movement and Sports Sciences
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine > RC1200 Sports Medicine
R Medicine > RM Therapeutics. Pharmacology
Divisions: Sport & Exercise Sciences
Publisher: Foundation for Rehabilitation Information
SWORD Depositor: A Symplectic
Date Deposited: 09 Jun 2022 11:10
Last Modified: 09 Jun 2022 11:15
DOI or ID number: 10.2340/16501977-2805
URI: https://researchonline.ljmu.ac.uk/id/eprint/17042
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