The effect of a combination of functional electrical stimulation and cycle ergometer (FES-cycling) on physiological changes and functional ability in patients with ICU-acquired weakness | [Anaesthesia, Pain and Intensive Care • 2023]

Author(s):

1. Arnengsih Nazir: Department of Physical & Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital, Faculty of Medicine, Padjadjaran University, Jl. Pasteur No. 38, Bandung, West Java, Indonesia

Abstract:

Intensive care unit-acquired weakness (ICU-AW) is the most common complication found in the intensive care unit (ICU) patients, especially those on prolonged use of mechanical ventilation (MV). It is known to cause poor longterm outcomes, and early rehabilitation (ER) intervention has been proved to be useful in improving muscle strength, physical function, and quality of life of ICU survivors. Several obstacles, such as patients' medical condition and limited availability of equipment or trained personnel, interfere with ER. Passive ER including functional electrical stimulation (FES) and cycling were found to be effective. The combination of FES with a cycle ergometer (FES cycling) can be implemented, but research on using this modality in the ICU is still limited. This review aimed at providing information on the use of FES cycling in ICU patients to explain its effect on physiological changes and functional abilities. The physiological effects of FES cycling are obtained through local metabolic changes in muscles due to FES and increased cardiovascular responses due to muscle contraction during cycling. Its effects on muscle strength, cross-section area, days free of MV, mobilization, cognitive ability, delirium, and quality of life were positive, and only rarely adverse events occurred during the intervention. To conclude, the use of FES cycling in the prevention and treatment of ICU-AW can be considered since this modality causes positive physiological effects and has proven safe. Abbreviations: EM - Early Mobilization; ER- early rehabilitation; FES - functional electrical stimulation; ICU-AW Intensive Care Unit-Acquired Weakness; MV - mechanical ventilation; NMBA - neuromuscular blocking agents; PICS - post-intensive care syndrome; NMES - neuromuscular electrical stimulation;

Page(s): 599-606

DOI: 10.35975/apic.v27i5.2315

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 27, Issue: 5, Year: 2023

Keywords:

Intensive care unit , Muscle strength , Quality of life , Electrical Stimulation , Muscle Contraction

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