• Tomoya Hirose, Tadahiko Shiozaki, Kentaro Shimizu, Tomoyoshi Mouri, Kazuo Noguchi, Mitsuo Ohnishi, and Takeshi Shimazu.
• Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. htomoya1979@hp-emerg.med.osaka-u.ac.jp
• J Crit Care. 2013 Aug 1; 28 (4): 536.e1-7.

PurposeDisuse atrophy of the lower limbs of patients with consciousness disturbance has often been recognized as "an unavoidable consequence," such that the mechanism was not investigated diligently. In this study, we examined the preventive effects of electrical muscle stimulation (EMS) against disuse atrophy of the lower limbs in patients in coma after stroke or traumatic brain injury in the intensive care unit.Materials And MethodsWe evaluated changes in cross-sectional area of lower limb muscles weekly with computed tomography in 6 control group patients and 9 EMS group patients. Electrical muscle stimulation was performed daily from day 7 after admission. We evaluated the anterior thigh muscle compartment, posterior thigh muscle compartment, anterior leg muscle compartment, and posterior leg muscle compartment.ResultsIn the control group, the decrease in cross-sectional area progressed in all compartments every week (P < .0001). Cross-sectional areas of all compartments at day 14 were significantly decreased in the control group compared with those in the EMS group at day 7 (P < .001). We were able to limit the rate of muscle atrophy as measured in the cross-sectional areas to within 4% during the period of EMS (days 7-42) in 5 patients. The difference between the control and the EMS groups was statistically significant (P < .001).ConclusionElectrical muscle stimulation is effective in the prevention of disuse muscle atrophy in patients with consciousness disorder.Copyright © 2013 Elsevier Inc. All rights reserved.

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