Development of neuromuscular electrical stimulation training with passive motion for the treatment of ICU-acquired weakness

2020 Fiscal Year Final Research Report

• Project/Area Number: 17H02123
• Research Category: Grant-in-Aid for Scientific Research (B)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Sapporo Medical University
• Principal Investigator: Yamada Takashi 札幌医科大学, 保健医療学部, 准教授 (50583176)
• Co-Investigator(Kenkyū-buntansha): 今井 富裕 札幌医科大学, 保健医療学部, 教授 (40231162)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Keywords: ICU関連筋力低下 / 膜興奮性 / 筋原線維機能 / メカニカルサイレンシング / 神経筋電気刺激 / 関節他動運動

Outline of Final Research Achievements

We investigated the effect of neuromuscular electrical stimulation (ES) with passive motion (PM) on ICU-acquired weakness (ICUAW). Animal studies using steroid-denervation (SD) and denervation (DEN) rats revealed that impaired membrane excitability and myofibrillar dysfunction are two major cellular defects underlying ICUAW that are likely to be caused by mechanical silencing. Importantly, ES training ameliorated the SD- and DEN-induced myofibrillar dysfunction, whereas these beneficial effects of ES were not enhanced by a combination of ES and PM. On the basis of these findings, we examined the effect of ES training on patients with ICUAW and found a trend towards prevention of reduction in torque production. Further data collection is planned to reach statistical power.

Free Research Field

筋機能制御学

Academic Significance and Societal Importance of the Research Achievements

ICUにおいて，超急性期よりリハビリテーションを開始して早期離床を早めることは，人工呼吸器離脱期間および入院期間の短縮やQOLの向上に効果がある（米国集中治療医学会）．ただし，我が国において超急性期リハビリテーションのエビデンスはほとんど存在しない．本研究の成果は，ICU関連筋力低下の病態メカニズムの解明に寄与するとともに，科学的根拠に基づいた安心・安全で効果的な超急性期リハビリテーションプログラムの確立，普及に寄与するものであると考えられ，ICU患者の早期離床を促すとともに，その後のADLおよびQOLの獲得など予後の改善に効果を及ぼすことが期待される．