Every patient admitted to the ICU is at risk of developing ICU Acquired Weakness (ICUAW). ICUAW begins within the first couple hours of hospitalization with approximately 11% of muscle strength is lost per day. Further, 2.4 million patients per year in the US develop an advanced form of ICUAW which is associated with increased rate of mortality, prolonged duration of mechanical ventilation, ICU and hospital stay, rehabilitation time, and reduced quality of life. To mitigate ICUAW, early mobility is the lone strategy readily available to clinicians to thwart ICUAW. Early mobility programs require patient's cooperation and numerous ICU staff safely implement the intervention. Thus, uncooperative patients are excluded from mobility efforts. Clearly, interventions that can be implemented with most any ICU patient are urgently needed. Electrical muscle stimulation (EMS) is uniquely capable of addressing this need by contracting muscles using skin-surface electrodes and electrical pulses. Clinical data assessing the feasibility, safety, and efficacy of such intervention is promising. However, technical limitations such as lack of electric safety in commercially available devices, and the need for a skilled operator to install, setup, and monitor the treatment session render the application of electrical muscle stimulation as a tool for early rehabilitation in the ICU complex and expensive. To solve this problem, Health Discovery Labs is developing an easy-to-use closed loop electrical muscle stimulation system (CL-EMS) with improved electric safety. The objective of this interventional, open label single group feasibility study is to assess whether the MyokinE100 (CL-EMS alpha) device developed by Health Discovery Labs will interfere with cardiac monitoring devices commonly used in ICU settings while inducing muscle contraction or twitching.

In Simulation Lab ICU setting, at the Ascension Texas Clinical Education Center (CEC), healthy volunteers will be placed in supine position on an electrically powered ICU bed, connected to the cardiac monitor system, and to an external defibrillator in monitor mode. A pair of garments containing off-the-shelf (OTS) electrodes will be wrapped around the thigh area (both right and left lower limb) and connected to the MyokinE100 (CL-EMS alpha) device developed by Health Discovery Labs. Volunteers will receive electrical muscle stimulation of contralateral muscle groups for a total of 25 minutes. Before and during the electrical muscle stimulation process, data related to the ECG patterns will be collected from the ECG monitoring system, and the external defibrillator. Data related to the applied electrical pulse characteristics will be collected from the device. Muscle response to electrical stimulation will be objectively graded by the research team based on a scale for rating the quality of muscle contractions. Comfort level will be graded by the volunteer using the Numeric Rating Scale (NRS).

Success will be judged based on the following criteria: (1) the use of the MyokinE100 (CL-EMS alpha) device does not induce ECG noise of more than 0.1mV in amplitude in at least 70% of the healthy volunteers; (2) does not introduce signals suggestive of cardiac dysrhythmias (VF/VT/AF/PVC/PAC) in at least 70% of the healthy volunteers; and (3) induces visible muscle contraction at the level of the quadriceps muscle group in at least 70% of the healthy volunteers.