Authors (including presenting author) :
Tse PY(1), Chan WY(1), Lai MC(1), Tsang HC(1), To YL(1)
Affiliation :
(1)Physiotherapy department, North District Hospital
Keyword 1: :
intensive care unit
Keyword 2: :
electical simulation
Keyword 3: :
muscle wasting
Keyword 4: :
early mobilization
Introduction :
Intensive care unit (ICU) acquired weakness is prevalent among critically ill patients and it is associated with longer duration of mechanical ventilation and prolonged length of stay(LoS)[1].Current practice encourages early mobilization(EM) for patients in ICU and lower limb ergometry exercise(LLEE) was commonly used. However, its therapeutic effect was limited by patient’s conscious level. Studies reported that electrical stimulation(ES) alleviated muscle loss in ICU patients [2]. This study aimed to investigate whether an addition of electrical stimulation during LLEE could better preserve lower limbs muscles and reduce LoS.
Objectives :
To investigate whether addition of electrical stimulation during LLEE could preserve lower limbs muscles and reduce LOS.
Methodology :
This was a prospective cohort pilot study conducted in the ICU of North District Hospital from March 2025 to November 2025. ICU patients receiving EM including in-bed cycling, bedside standing/stepping and assisted walking, were randomly assigned into study and control group. Both groups performed LE as soon as possible daily, while only the study group received ES via Fesia bike machines during LLEE. Quadriceps thickness(QT) was measured using ultrasound at the junction of lower third and upper two-thirds between the anterior superior iliac spine and the upper border of patella. Measurement was taken within 48hours of ICU admission and on the day of discharge. Patients with pre-existing neuromuscular pathology, lower-limb amputation, lower limb orthopedic surgery, terminal illness and or those who completed fewer than two LLEE sessions were excluded. Independent T-Test was used to compare in percentage decrease in QT between groups, while Mann-Whitney U test was applied to analyze difference in LoS and change in ICU mobility scale (ICUMS).
Result & Outcome :
Thirty-three patients were recruited in this study with 14 in control group and 19 in study group. The percentage decrease in QT was 9.65% in control group and 9.17% in study group. The study group showed a significantly smaller decrease in QT (p=0.047). The average LoS was shorter in study group(6.68day) compared to control group(9.64day), though this difference was not statistically significant.(p=0.174) Similarly, the improvement in ICUMS was greater in study group (5score) than in control group(4score), and yet, did not reach statistical significance (p=0.190). Despite the lack of statistical significance which likely due to the small sample size, the observed reductions in LoS and improvement in functional status are considered clinically meaningful. In conclusion, addition of ES during LLEE demonstrated a protective effect against lower limb muscle wasting. It may also potentially contribute to shorter LoS and better functional status in critically ill patients.
