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AzTrials

Critical IllnessNCT05287919

Neuromuscular Electrical Stimulation (NMES) Preserves Muscle Mass in Intensive Care Unit (ICU)

A study testing Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day., Patients received the low-frequency neuromuscular electrical stimulation (NMES) and Patients received the medium-frequency neuromuscular electrical stimulation (NMES) in people with Critical Illness and Physical Disability, run by Gabriel Nasri Marzuca-Nassr at 1 site in Chile.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: Low-frequency neuromuscular electrical stimulation (NMES) attenuates the loss of muscle mass of Intensive Care Unit (ICU) patients. However, it has been shown that medium-frequency NMES may be better than low-frequency for the maintenance of skeletal muscle mass in healthy subjects. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day., Patients received the low-frequency neuromuscular electrical stimulation (NMES) and Patients received the medium-frequency neuromuscular electrical stimulation (NMES)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
54 participants
Where
1 siteChile
Study dates
1 Aug 2019to 31 Jan 2020
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • patients between 18-80 years old admitted in ICU with requirement of mechanical ventilation (MV) for longer than 72 h.

Who cannot join

  • non-sedated patients;
  • spinal cord injury;
  • cerebrovascular accident;
  • patients with pacemakers;
  • history of deep vein thrombosis;
  • pregnancy;
Show all 9Show fewer
  • cardiac complications (history of myocardial infarction or congenital diseases);
  • use of neuromuscular blockers;
  • polytraumatized patients requiring tutor support.

Trial locations and contacts

1 site in 1 country.

Chile1 site
  • Department of Internal Medicine, Faculty of Medicine, Universidad de La Frontera

    Temuco, 4780000

Other trials in Chile

About this study

Official title: Effects of Low- and Medium-frequency Neuromuscular Electrical Stimulation on Skeletal Muscle Atrophy in Critically Ill Patients

Background: Low-frequency neuromuscular electrical stimulation (NMES) attenuates the loss of muscle mass of Intensive Care Unit (ICU) patients. However, it has been shown that medium-frequency NMES may be better than low-frequency for the maintenance of skeletal muscle mass in healthy subjects.

Objective: to compare the effects of low-frequency and medium-frequency NMES, along with a standard physical therapy (SPT) programme, on the attenuation of skeletal muscle atrophy in critically ill patients.

Methods: Fifty-four critically ill patients admitted into intensive care unit (ICU) and on mechanical ventilation (MV) participated in this randomized, single-blinded, experimental study. Participants were allocated to one of the following groups: Control Group (CG), received a standard lower limb physical therapy (SPT) programme, 2x/day; Low-frequency NMES Group (LFG), received lower limb SPT+NMES at 100 Hz, 2x/day; and Medium-frequency NMES Group (MFG), received lower limb SPT+NMES at 100 Hz and carrier frequency of 2500 Hz, 2x/day. The primary outcome was the thickness and quality of the quadriceps muscle, evaluated with ultrasonography while patients were in ICU. Secondary outcomes, assessed at various stages of recovery, were strength, functionality, independence for activities of daily living, quality of life, and total days hospitalized.

Read the detailed description

Background: Low-frequency neuromuscular electrical stimulation (NMES) attenuates the loss of muscle mass of Intensive Care Unit (ICU) patients. However, it has been shown that medium-frequency NMES may be better than low-frequency for the maintenance of skeletal muscle mass in healthy subjects.

Research question: The research question was is medium-frequency neuromuscular electrical stimulation (NMES) more effective than low-frequency NMES for the attenuation of skeletal muscle atrophy in critically ill patients?

Objective: To compare the effects of low-frequency and medium-frequency NMES, along with a standard physical therapy (SPT) programme, on the attenuation of skeletal muscle atrophy in critically ill patients.

Methods: Fifty-four critically ill patients admitted into intensive care unit (ICU) and on mechanical ventilation (MV) participated in this randomized, single-blinded, experimental study. Participants were allocated to one of the following groups: Control Group (CG), received a standard lower limb physical therapy (SPT) programme, 2x/day; Low-frequency NMES Group (LFG), received lower limb SPT+NMES at 100 Hz, 2x/day; and Medium-frequency NMES Group (MFG), received lower limb SPT+NMES at 100 Hz and carrier frequency of 2500 Hz, 2x/day. The primary outcome was the thickness and quality of the quadriceps muscle, evaluated with ultrasonography while patients were in ICU. Secondary outcomes, assessed at various stages of recovery, were muscle strength (MRC-SS), handgrip strength (dynamometry), functional status (FSS-ICU), degree of independence for activities of daily living (Barthel Index), functional mobility and dynamic balance (Timed Up and Go Test), quality of life (SF-36), and total days hospitalized.

Being tested
Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day., Patients received the low-frequency neuromuscular electrical stimulation (NMES), Patients received the medium-frequency neuromuscular electrical stimulation (NMES)
Keywords
electrical stimulation therapy, skeletal muscle atrophy, critically ill patient, physical therapy, intensive care unit
Medical subject headings
Critical Illness, Muscular Atrophy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day.Other

    All participants have received standard physical therapy (SPT) sessions based on a passive range of motion mobilization protocol for the lower limbs. It consisted of a bilateral series of 10 repetitions of hip flexion, knee flexion and extension, and ankle flexion and extension. The procedure was performed twice a day: a morning (between 8am - 12pm) and an afternoon session (between 2pm - 6pm).

  • Patients received the low-frequency neuromuscular electrical stimulation (NMES)Other

    Electrical stimulation was performed twice a day after SPT. Two electrodes were attached to each thigh at the motor points of the quadriceps muscle. The point halfway between the anterior superior iliac spine and the base of the patella was used as reference and electrodes were placed 15 cm apart each other, 5 cm proximal and 10 cm distal from the reference point. After the first measurement, semi-permanent markers were used to indicate the position of electrodes. Electrical stimulation was performed using a 4-channels device (Sonopuls 492, series 4, Enraf-Nonius®, Rotterdam, Netherlands). The low-frequency protocol consisted of 100 Hz and 400 ms width pulses, delivered in trains of 5 s ON (ramp-up time: 1 s, plateau: 3 s, ramp-down time: 1 s) and 10 s OFF. Sessions had 20 min of duration (total of 40 min/day) and the current amplitude (mA) was adjusted to the identification of visible and palpable contractions and was rectified every 3 min to sustain the initial level of contraction.

  • Patients received the medium-frequency neuromuscular electrical stimulation (NMES)Other

    Electrical stimulation was performed twice a day after SPT. Two electrodes were attached to each thigh at the motor points of the quadriceps muscle. The point halfway between the anterior superior iliac spine and the base of the patella was used as reference and electrodes were placed 15 cm apart each other, 5 cm proximal and 10 cm distal from the reference point. After the first measurement, semi-permanent markers were used to indicate the position of electrodes. Electrical stimulation was performed using a 4-channels device (Sonopuls 492, series 4, Enraf-Nonius®, Rotterdam, Netherlands).The medium-frequency protocol had similar parameters, but a carrier frequency of 2500 Hz and burst frequency of 100 Hz. Sessions had 20 min of duration (total of 40 min/day) and the current amplitude (mA) was adjusted to the identification of visible and palpable contractions and was rectified every 3 min to sustain the initial level of contraction.

Study groups in NCT05287919
Study groupRoleWhat they receive
Control groupOtherPatients received the standard physical therapy (SPT) programme only (passive mobilization) twice a day.
Receives: Other: Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day.
Low-frequency NMES groupExperimentalPatients submitted to low-frequency NMES and SPT twice a day.
Receives: Other: Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day.; Other: Patients received the low-frequency neuromuscular electrical stimulation (NMES)
Medium-frequency NMES groupExperimentalPatients submitted to medium-frequency NMES and SPT twice a day.
Receives: Other: Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day.; Other: Patients received the medium-frequency neuromuscular electrical stimulation (NMES)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in thickness of the quadriceps muscle, evaluated with ultrasonography while patients were in intensive critical unit (ICU).

    Thickness of the quadriceps muscle via ultrasonography (mm).

    Measured: Day 1, Day 5, Day 9

  2. Change in quality of the quadriceps muscle, evaluated with ultrasonography while patients were in intensive critical unit (ICU).

    Quality of the quadriceps muscle via ultrasonography by Heckmatt's rating scale.

    Muscle quality was estimated by Heckmatt's rating scale, which scores the ultrasound images between 1-4: 1) normal echogenicity; 2) slight increase in muscle echogenicity and normal bone reflection; 3) moderate increase in muscle echogenicity and reduced bone reflection; 4) large increase in muscle echogenicity and no bone reflection.

    Measured: Day 1, Day 5, Day 9

Secondary outcomes (6)
  1. Change in Clinical assessment of muscle strength while patients were in intensive care unit (ICU).

    Clinical assessment of muscle strength via Medical Research Council-Sum Score (MRC-SS) (points), which ranges from 0 (complete paralysis) to 60 (normal strength).

    Measured: Day 9, Day 11, Day 16, and Day 27

  2. Change in Handgrip strength while patients were in hospital stay.

    Handgrip strength via digital dynamometer (kg).

    Measured: Day 9, Day 11, Day 16, and Day 27

  3. Change in Functional status while patients were in Intensive Care unit (ICU).

    Functional status via Functional Status Score for the Intensive Care Unit (FSS-ICU) (points). FSS-]ICU FSS-ICU score has a range of 0-35 with higher score indicating better functional status.

    Measured: Day 9, Day 11, Day 16, and Day 27

  4. Change in dynamic balance while patients were in hospital stay.

    Dynamic balance via Timed Up and Go Test (seconds).

    Measured: Day 16, and Day 27

  5. Change in independence for activities of daily living while patients were in hospital stay.

    Independence for activities of daily living via Barthel index (points). A patient scoring 0 points would be dependent in all assessed activities of daily living, whereas a score of 100 would reflect independence in these activities.

    Measured: Day 16, and Day 27

  6. Change in quality of life prior to hospital discharge.

    Quality of life via Short Form 36 (SF-36) (points). The score go from 0 to 100. Higher scores mean a better outcome.

    Measured: Day 27

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted18 Mar 2022
  2. Study start1 Aug 2019
  3. Primary completion31 Jan 2020
  4. Study completion31 Jan 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
54 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05287919
Sponsor's protocol ID
Tesis UFRO #1676
Status last verified
Mar 2022
First submitted
19 Feb 2022
Last updated
18 Mar 2022
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Guerra-Vega P, Guzman R, Betancourt C, Grage M, Vera C, Artigas-Arias M, Munoz-Cofre R, Vitzel KF, Marzuca-Nassr GN. Medium-Frequency Neuromuscular Electrical Stimulation in Critically Ill Patients Promoted Larger Functional Capacity Improvement During Recovery than Low-Frequency Neuromuscular Electrical Stimulation: Randomized Clinical Trial. J Clin Med. 2025 Jul 31;14(15):5407. doi: 10.3390/jcm14155407.

    PubMed 40807029

Questions about this trial

What is this clinical trial studying?

A study testing Patients received the standard physical therapy (SPT) programme (passive mobilization) twice a day., Patients received the low-frequency neuromuscular electrical stimulation (NMES) and Patients received the medium-frequency neuromuscular electrical stimulation (NMES) in people with Critical Illness and Physical Disability, run by Gabriel Nasri Marzuca-Nassr at 1 site in Chile.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Chile. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in thickness of the quadriceps muscle, evaluated with ultrasonography while patients were in intensive critical unit (ICU). (time frame: Day 1, Day 5, Day 9). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05287919, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2022.

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