The role of neuromuscular electrical stimulation in improving peripheral muscle strength in chronically ill bedbound patients
Bibliographic record
Abstract
Chronically ill patients undergoing prolonged bedrest in the intensive care unit and long-term care facilities typically experience a marked loss of muscle mass, particularly in the lower limbs, translating into clinically significant muscular weakness. Both muscle atrophy and weakness can be present following only one week of stay in the ICU. Following discharge from the hospital, functional limitations may persist for years and impede their return to activities of daily living, thus highlighting the importance of developing an effective intervention against disuse-related muscle atrophy and weakness. This thesis aimed to evaluate the feasibility of application of neuromuscular electrical stimulation (NMES) in chronically ill bedridden (CIB) patients and the efficacy of NMES in both improving muscle strength and attenuating lower limb muscle atrophy during their hospitalization. Four CIB patients (76 ± 7 years) underwent 15 NMES sessions of the quadriceps muscle over a period of 3 weeks. In each patient, one leg was randomly designated to receive treatment (TRT) with NMES and usual care and the control (CTL) leg received sham stimulation with usual care from the physiotherapist consisting of mobilization sessions of the upper and lower limbs. Efficacy of NMES was assessed pre and post intervention through determination of maximal quadricep strength and muscle size through ultrasound muscle imaging. The muscle strength response was variable, with 2 of 4 patients demonstrating increases (by 10 and 40%) and the lack of increase in muscle mass in these patients suggests neural adaptation as the underlying mechanism, not hypertrophy in this 3-week NMES protocol. Although the protocol was well tolerated by all patients, overall, feasibility was poor due to recruitment difficulties including the presence of lower limb oedema and neuromuscular disease. We posit that NMES may be effective in improving lower limb strength in bedbound patients, however future multi-center trials are needed to ensure sufficient patient recruitment in order to confirm efficacy of NMES in improving muscle strength in CIB patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".