Kotaro Iwatsu1, Yuki Iida2, Yuji Kono3, Takenori Yamazaki4, Akihiko Usui5, Sumio Yamada6. 1. Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan. 2. Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Physiotherapy, Kainan Hospital, Yatomi, Japan. 3. Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan. 4. Department of Cardiovascular Surgery, Kainan Hospital, Yatomi, Japan. 5. Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. 6. Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: yamadas@met.nagoya-u.ac.jp.
Abstract
OBJECTIVE: To explore the efficacy of postoperative neuromuscular electrical stimulation (NMES) on muscle protein degradation and muscle weakness in patients after cardiovascular surgery. METHODS: Sixty-one patients underwent NMES daily from postoperative days (PODs) 1 to 5 in addition to postoperative mobilization program (NMES group), and 41 patients underwent postoperative mobilization program only (non-NMES group). The primary outcome was the concentration of 3-methylhistidine (3-MH) in 24-hour urine corrected for urinary creatinine content (3-MH/Cre) from PODs 1 to 5. The secondary outcomes were knee extensor isometric strength (KEIS) and handgrip strength at POD 7. RESULTS: Baseline characteristics such as age, sex, preoperative body mass index, hemoglobin, handgrip strength, KEIS, surgery type, cardiopulmonary bypass time, and immediate postoperative interleukin-6 were not different between the groups. Urinary 3-MH/Cre was increased significantly in both groups; however, urinary 3-MH/Cre in the NMES group peaked earlier compared with that in the non-NMES group. KEIS at POD 7 was significantly greater in the NMES group (median [interquartile range], 0.40 kg/weight [0.33-0.45] in the NMES group vs 0.23 kg/weight [0.15-0.36] in the non-NMES group; P < .01). Handgrip strength at POD 7 was also significantly greater in the NMES group (median [interquartile range], 32 kg [24.5-35.3] in the NMES group vs 24 kg [16.0-30.0] in the non-NMES group; P < .01). CONCLUSIONS: This study demonstrated that NMES might attenuate skeletal muscle protein degradation and muscle weakness after cardiovascular surgery. A cause-effect relationship between NMES and functional preservation would be a future challenging issue.
OBJECTIVE: To explore the efficacy of postoperative neuromuscular electrical stimulation (NMES) on muscle protein degradation and muscle weakness in patients after cardiovascular surgery. METHODS: Sixty-one patients underwent NMES daily from postoperative days (PODs) 1 to 5 in addition to postoperative mobilization program (NMES group), and 41 patients underwent postoperative mobilization program only (non-NMES group). The primary outcome was the concentration of 3-methylhistidine (3-MH) in 24-hour urine corrected for urinary creatinine content (3-MH/Cre) from PODs 1 to 5. The secondary outcomes were knee extensor isometric strength (KEIS) and handgrip strength at POD 7. RESULTS: Baseline characteristics such as age, sex, preoperative body mass index, hemoglobin, handgrip strength, KEIS, surgery type, cardiopulmonary bypass time, and immediate postoperative interleukin-6 were not different between the groups. Urinary 3-MH/Cre was increased significantly in both groups; however, urinary 3-MH/Cre in the NMES group peaked earlier compared with that in the non-NMES group. KEIS at POD 7 was significantly greater in the NMES group (median [interquartile range], 0.40 kg/weight [0.33-0.45] in the NMES group vs 0.23 kg/weight [0.15-0.36] in the non-NMES group; P < .01). Handgrip strength at POD 7 was also significantly greater in the NMES group (median [interquartile range], 32 kg [24.5-35.3] in the NMES group vs 24 kg [16.0-30.0] in the non-NMES group; P < .01). CONCLUSIONS: This study demonstrated that NMES might attenuate skeletal muscle protein degradation and muscle weakness after cardiovascular surgery. A cause-effect relationship between NMES and functional preservation would be a future challenging issue.
Authors: Telma Cristina Fontes Cerqueira; Manoel Luiz de Cerqueira Neto; Lucas de Assis Pereira Cacau; Géssica Uruga Oliveira; Walderi Monteiro da Silva Júnior; Vitor Oliveira Carvalho; José Teles de Mendonça; Valter Joviniano de Santana Filho Journal: Medicine (Baltimore) Date: 2018-11 Impact factor: 1.817