No outcomes evaluated the effect on participation restrictions .
NMES , as an adjunct to current rehabilitation practice s in critically ill patients , may maintain muscle strength .
OBJECTIVE To review , in conformance with the Preferred Reporting Items for Systematic Review s and Meta-Analyses guidelines , the totality of evidence for the use of neuromuscular electrical stimulation ( NMES ) in the critical care setting , when compared with usual care , under all domains of the World Health Organisation , International Classification of Functioning , Disability and Health ( ICF ) framework .
Paresis acquired in the intensive care unit: a prospective multicenter study.
CONTEXT Although electrophysiologic and histologic neuromuscular abnormalities are common in intensive care unit ( ICU ) patients , the clinical incidence of ICU-acquired neuromuscular disorders in patients recovering from severe illness remains unknown . OBJECTIVES To assess the clinical incidence , risk factors , and outcomes of ICU-acquired paresis ( ICUAP ) during recovery from critical illness in the ICU and to determine the electrophysiologic and histologic patterns in patients with ICUAP . DESIGN Prospect i ve cohort study conducted from March 1999 to June 2000 . SETTING Three medical and 2 surgical ICUs in 4 hospitals in France . PARTICIPANTS All consecutive ICU patients without preexisting neuromuscular disease who underwent mechanical ventilation for 7 or more days were screened daily for awakening . The first day a patient was considered awake was day 1 . Patients with severe muscle weakness on day 7 were considered to have ICUAP . MAIN OUTCOME MEASURES Incidence and duration of ICUAP , risk factors for ICUAP , and comparative duration of mechanical ventilation between ICUAP and control patients . RESULTS Among the 95 patients who achieved satisfactory awakening , the incidence of ICUAP was 25.3 % ( 95 % confidence interval [ CI ] , 16.9%-35.2 % ) . All ICUAP patients had a sensorimotor axonopathy , and all patients who underwent a muscle biopsy had specific muscle involvement not related to nerve involvement . The median duration of ICUAP after day 1 was 21 days . Mean ( SD ) duration of mechanical ventilation after day 1 was significantly longer in patients with ICUAP compared with those without ( 18.2 [ 36.3 ] vs 7.6 [ 19.2 ] days ; P = .03 ) . Independent predictors of ICUAP were female sex ( odds ratio [ OR ] , 4.66 ; 95 % CI , 1.19 - 18.30 ) , the number of days with dysfunction of 2 or more organs ( OR , 1.28 ; 95 % CI , 1.11 - 1.49 ) , duration of mechanical ventilation ( OR , 1.10 ; 95 % CI , 1.00 - 1.22 ) , and administration of corticosteroids  ( OR , 14.90 ; 95 % CI , 3.20 - 69.80 ) before day 1 . CONCLUSIONS Identified using simple bedside clinical criteria , ICUAP was frequent during recovery from critical illness and was associated with a prolonged duration of mechanical ventilation . Our findings suggest an important role of corticosteroids in the development of ICUAP
No outcomes evaluated the effect on participation restrictions .
NMES , as an adjunct to current rehabilitation practice s in critically ill patients , may maintain muscle strength .
OBJECTIVE To review , in conformance with the Preferred Reporting Items for Systematic Review s and Meta-Analyses guidelines , the totality of evidence for the use of neuromuscular electrical stimulation ( NMES ) in the critical care setting , when compared with usual care , under all domains of the World Health Organisation , International Classification of Functioning , Disability and Health ( ICF ) framework .