Background Deep and respiratory muscle disorders are commonly observed in critically ill patients. Neuromuscular electrical stimulation (NMES) is an alternative to mobilize and to exercise that does not require active patient participation and can be used on bedridden patients. Objective Evaluate the effectiveness of the NMES therapy in quadriceps versus diaphragm subjects in mechanical ventilation (MV). Methods Sixty-seven subjects in MV were included, divided into 3 groups: (a) control group (CG, n=26), (b) stimulation of quadriceps (quadriceps group–QG, n=24), and (c) stimulation of diaphragm (diaphragm group–DG, n=17). The QG and DG patients received consecutive daily electrical stimulation sessions at specific points from the first day of randomization until ICU discharge. Respiratory and peripheral muscle strength, MV time, length of hospitalization, and functional independence score (the Functional Status Score-ICU) were recorded. Results There were studied n=24 (QG), n=17 (DG), and n=26 (CG) patients. Peripheral muscle strength improved significantly in the QG (p=0.030). Functional independence at ICU discharge was significantly better in QG (p=0.013), and the QG presented a better Barthel Index compared to DG and CG (p=0.0049) and also presented better FSS compared to CG (p=0.001). Conclusions Electrical stimulation of quadriceps had best outcomes for peripheral muscle strength compared with controls or electrical stimulation of diaphragm among mechanically ventilated critically ill subjects and promoted functional independence and decreased length of hospitalization.
Introdução: Não há um consenso sobre frequência, intensidade, número de repetições e tempo de duração do alongamento muscular. Objetivo: Verificar em que tempo, 15 ou 30 s, é produzido maior ganho de extensibilidade após a intervenção e no decorrer do tempo. Métodos: A amostra foi composta por 16 mulheres com retração de isquiotibiais, divididas em dois grupos, com protocolos em três séries de alongamento estático. O G1 realizou alongamento durante 15s; e o G2, em 30s. Utilizou-se um período controle entre avaliações (AV1-AV2) de sete dias, em seguida, ocorreram os alongamentos por cinco dias consecutivos, com nova avaliação ao final destes (AV3); após dois dias sem intervenção (AV4), e finalmente após cinco dias (AV5). Resultados e Conclusão: Para o G1 e o G2, houve aumento da extensibilidade, mas, na comparação entre os grupos, o G2 mostrou maior aumento e manutenção dos valores.
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