• Evangelia Koutsioumpa, Demosthenes Makris, Athina Theochari, Dimitra Bagka, Stathis Stathakis, Efstratios Manoulakas, Markos Sgantzos, and Epaminondas Zakynthinos.
• Evangelia Koutsioumpa is a physiotherapist, Athina Theochari is a nurse, and Dimitra Bagka and Efstratios Manoulakas are physicians, intensive care unit, University General Hospital of Larissa, Thessaly, Greece. Demosthenes Makris and Epaminondas Zakynthinos are professors, intensive care medicine, Stathis Stathakis is a physician, Anatomy Section, and Markos Sgantzos is a professor, anatomy and history of medicine, Faculty of Health Sciences, University of Thessaly, Larissa, Greece. evkou333@yahoo.gr.
• Am. J. Crit. Care. 2018 Nov 1; 27 (6): 495-503.

BackgroundCritical illness polyneuropathy or myopathy is a severe disorder that may adversely affect patients in the intensive care unit, resulting in reduced mobilization, decline in muscle mass, and prolonged recovery periods.ObjectiveTo examine whether the application of trans-cutaneous electrical neuromuscular stimulation (TENMS) reduces the incidence or severity of myopathy related to critical illness in intensive care unit patients.MethodsA total of 80 patients aged 18 years or older with an intensive care unit stay of 96 hours or more and receipt of mechanical ventilation for 96 hours or more were initially enrolled in a prospective, open-label randomized controlled trial in a university hospital. Patients received either conventional physical therapy alone (control group) or conventional physical therapy plus TENMS (TENMS group) for 10 days. Myopathy was assessed histologically (by needle biopsy of the quadriceps muscles) on the 4th and 14th days of the intensive care unit stay.ResultsOf the 68 patients who completed the study, 27 (40%) had myopathy on the 14th day: 11 patients in the TENMS group (9 mild, 1 moderate, and 1 severe) and 16 patients in the control group (13 mild, 2 moderate, and 1 severe). Patients who progressed from mild to moderate or severe myopathy between the 4th and 14th days had significantly lower body mass index (P = .001) and longer time periods with inadequate nutrition (P = .049) compared with the other patients. Mean (SD) Rankin scale scores at 6 months were 3.2 (1.8) and 3.8 (2.1) in the TENMS and control groups, respectively (P = .09).ConclusionTENMS had no significant impact on myopathy in the critically ill patients in this study.©2018 American Association of Critical-Care Nurses.

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