Neuromuscular electrical stimulation for preventing skeletal-muscle weakness and wasting in critically ill patients: A systematic review

Background: Neuromuscular electrical stimulation (NMES) therapy may be useful in early musculoskeletal rehabilitation during acute critical illness. The objective of this systematic review was to evaluate the effectiveness of NMES for preventing skeletal-muscle weakness and wasting in critically ill patients, in comparison with usual care.Methods: We searched PubMed, CENTRAL, CINAHL, Web of Science, and PEDro to identify randomized controlled trials exploring the effect of NMES in critically ill patients, which had a well-defined NMES protocol, provided outcomes related to skeletal-muscle strength and/or mass, and for which full text was available. Two independent reviewers extracted data on muscle-related outcomes (strength and mass), and participant and intervention characteristics, and assessed the methodological quality of the studies. Owing to the lack of means and standard deviations (SDs) in some studies, as well as the lack of baseline measurements in two studies, it was impossible to conduct a full meta-analysis. When means and SDs were provided, the effect sizes of individual outcomes were calculated, and otherwise, a qualitative analysis was performed.Results: The search yielded 8 eligible studies involving 172 patients. The methodological quality of the studies was moderate to high. Five studies reported an increase in strength or better preservation of strength with NMES, with one study having a large effect size. Two studies found better preservation of muscle mass with NMES, with small to moderate effect sizes, while no significant benefits were found in two other studies.Conclusions: NMES added to usual care proved to be more effective than usual care alone for preventing skeletal-muscle weakness in critically ill patients. However, there is inconclusive evidence for its benefit in prevention of muscle wasting. © 2013 Maffiuletti et al.; licensee BioMed Central Ltd

Assessment of ventilatory threshold using near-infrared spectroscopy on the gastrocnemius muscle during treadmill running

This study was designed to investigate the efficacy of the near-infrared spectroscopy (NIRS) methodology in exploring the relationship between ventilatory (VT) and NIRS-determined threshold on the gastrocnemius muscle during running. Seventeen healthy participants, 11 males and 6 females performed an incremental exercise test until volitional exhaustion on a treadmill. Initial speed was set at 8 km/h with increments of 0.5 km/h per minute. Tissue oxygen saturation (StO2) was obtained from the belly of the left gastrocnemius muscle. Running velocity at the NIRS threshold was evaluated with StO2-velocity plots, employing two different models: linear (NTlin) and Dmax (NTD). Significant difference in velocity was observed between NTD (11.7 ± 0.9 km/h) and VT (11.2 ± 1.2 km/h). However, no difference in velocity was observed between VT and NTlin (11.6 ± 0.8 km/h, p > 0.05), and between the two NIRS methods (p > 0.05). VT velocity was significantly correlated (p < 0.05) to NTlin (r = 0.86) and NTD (r = 0.84). Time duration at NIRS threshold as assessed with StO2-time plots employing a linear model (NT), did not differ from VT (8.5 ± 1.8 min vs. 7.9 ± 2.5 min respectively, p > 0.05). Furthermore, small but significant differences (p < 0.05) were found between VO2 and heart rate at VT and NT, expressed in either relative or maximum percentage values. Both NIRS-derived models were well correlated with VT and did not differ from each other. NIRS methodology applied on the gastrocnemius muscle was found to provide a useful means of detecting VT during treadmill running and to be practically appropriate in prescribing exercise training in running. Relevance to industry: Human performance assessment is useful in the field of occupational health or industry. Ventilatory threshold along with NIRS methodology could be used in the field or a simulated environment to evaluate performance of professionals involved in physically demanding activities, such as firefighting and construction. © 2009 Elsevier B.V. All rights reserved

Correlation of the running-based anaerobic sprint test (RAST) and performance on the 100m, 200m and 400m distance tests

Etude effectuée avec 28 athlètes hommes et femmes, réalisant 6 sprints maximaux sur 35 mètres, espacés par 10 secondes de repos (test RASTde l'université de Wolverhampton, Royaume Uni)

Acute cardiorespiratory responses to different exercise modalities in chronic heart failure patients—a pilot study

The purpose of this study was to compare the acute cardiorespiratory responses and time spent above different %VO2peak intensities between three “iso-work” protocols: (a) a high intensity interval training protocol (HIIT), (b) a higher intensity continuous protocol (CON70) and (c) a lower intensity continuous protocol (CON50) in patients with chronic heart failure (CHF). Ten male CHF patients (aged 55.1 ± 16.2 years) performed in separate days a single session of a HIIT protocol consisted of 4 sets × 4 min cycling at 80% VO2peak with 3 min of recovery at 50% VO2peak, a CON70 protocol corresponding to 70% VO2peak and a CON50 protocol corresponding to 50% VO2peak. Cardiopulmonary data were collected by an online gas analysis system. The HIIT and CON70 elicited higher cardiorespiratory responses compared to CON50 with no differences between them (p > 0.05). In HIIT and CON70, patients exercised longer at >80% and >90% VO2peak. The completion rate was 100% for the three protocols. Not any adverse events were observed in either protocol. Both HIIT and CON70 elicited a stronger physiological stimulus and required shorter time than CON50. Both HIIT and CON70 also induced comparable hemodynamic responses and ventilatory demand. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Impact of supervised aerobic exercise on clinical physiological and mental parameters of people living with HIV: a systematic review and meta-analyses of randomized controlled trials

Background: The benefits derived from supervised aerobic exercise in people living with human immunofeficiency virus– HIV (PLWH) have not yet been clearly identified. Objective: To evaluate the impact of supervised aerobic exercise on immunological, cardiorespiratory, pulmonary, hemodynamic and mental parameters of PLWH. Methods: A systematic review was carried out in accordance to PRISMA guidelines. PubMed, Physiotherapy Evidence Database (PEDro) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened up to August 2021, for the identification of English written randomized trials, with participants aged 18 years and older, at any stage of the disease, with or without co-morbidities. The risk of bias assessment was conducted according to the Cochrane Collaboration’s tool for assessing risk of bias. Meta- analyses were conducted using continuous, inverse variance, random-effects model. Results: Ten studies were suitable for meta-analysis based on inclusion criteria. Supervised aerobic exercise appeared to have beneficial effects on depressive symptoms [mean difference (MD)= −4.18 (confidence interval (CI)= (−6.55)–(−1.81), Z = 3.46, p = 0.0005, I2=0%, n = 2], forced expiratory volume in 1 sec [MD = 0.70, CI = 0.39–1.00, Z = 4.41, p < 0.0001, I2=0%, n = 2], and on the maximum oxygen uptake [MD = 1.38, CI = −0.02–2.78, Z = 1.94, p = 0.05, I2=94%, n = 4] of PLWH. No exercise effect was found for CD4 T-cell count (p = 0.16, n = 5), systolic blood pressure (p = 0.91, n = 2) and diastolic blood pressure (p = 0.72, n = 2). Conclusions: Supervised continuous aerobic exercise may improve lung function, depressive symptomatology and aerobic capacity of PLWH, however, the small number of available studies and the high heterogeneity concerning VO2max demonstrate the need for more research in this area. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group