To assess the effects of NMES on preventing muscle mass, strength, and functionality loss in patients with sepsis and septic shock.
The study was approved by the Research Ethics Committee (number 3.999.139). This is a randomized, controlled, double-blind clinical trial. Thirty-five ICU-admitted patients were randomized into the NMES experimental group (n=18) or the sham group (n=17). In the experimental NMES group, the vastus medialis and lateralis were stimulated at 100 hertz, with a pulse width of 350 μs, pulse ramp-up time of 1 second, on-time of 4 seconds, off-time of 12 seconds, and ramp-down time of 1 second. The current intensity was adjusted daily throughout the intervention to achieve visible muscle contraction, gradually increasing to the patient’s maximum tolerance. The sham group followed the same protocol, except the frequency was set at 5 Hz, and the intensity was minimized, only enough for the patient to perceive the current without generating palpable or visible muscle contraction. The experimental protocol was applied by the same physiotherapist in 40-minute sessions for seven consecutive days. Patients were evaluated on days 1, 5, and 8.
The cross-sectional area of the rectus femoris in the sham group significantly decreased from day 1 to day 5 and from day 1 to day 8, while the experimental group maintained muscle mass. The experimental group showed a significant reduction in echogenicity, whereas the sham group maintained it by day 8. All patients demonstrated an increase in MRC scores and a reduction in the strength domain of the ICF from day 1 to day 8. P-FIT and DEMMI scores significantly improved by day 8.
NMES prevented muscle mass loss in patients with sepsis and septic shock, and improved muscle strength and functionality.
NMES is a therapeutic intervention recommended for critical patients who are not yet able to achieve an upright posture. As a result, it was able to prevent muscle mass loss in patients with sepsis and septic shock.
muscle mass
critical care
