The development of critical patient related generalized neuromuscular weakness, referred to as critical illness polyneuropathy (CIP) and critical illness myopathy (CIM), is a major complication in patients admitted to intensive care units (ICU). Both CIP and CIM cause muscle weakness and paresis in critically ill patients during their ICU stay. Early mobilization or kinesiotherapy have shown muscle weakness reversion in critically ill patients providing faster return to function, reducing weaning time, and length of hospitalization. Exercises in the form of passive, active, and resisted forms have proved to improve strength and psychological well being. Clinical trials using neuromuscular electrical stimulation to increase muscle mass, muscle strength and improve blood circulation to the surrounding tissue have proved beneficial. The role of electrical stimulation is unproven as yet. Recent evidence indicates no difference between treated and untreated muscles. Future research is recommended to conduct clinical trials using neuromuscular electrical stimulation, exercises, and early mobilization as a treatment protocol in larger populations of patients in ICU.
Jones A. Evidence based physiotherapy in intensive care. Hong Kong Physioth J 2000;18:47-52.
Denhy L, Berney S. Physiotherapy in intensive care unit. Phys Ther Rev 2006;11:49-56.
Stiller K. Physiotherapy in Intensive Care: Towards an Evidence-Based Practice. Chest 2000;118:1801-13.
Stevens RD, Dowdy DW, Michaels RK, Mendez -Tellez PA, Pronovost PJ, Needham DM. Nueromuscular dysfunction acquired in critical care illness. Int Care Med 2007;33:1876-91.
Latronico N, Bertolini G, Guarneri B, Botteri M, Peli E, Andreoletti S, et al. Simplified electrophysiological evaluation of peripheral nerves in critically ill patients: The Italian multi-center CRIMYNE study. Crit Care 2007;11:R11.
Bolton CF, Gilbert JJ, Hahn AF, Sibbald W. Ployneuropathy in critical ill patients. J Neurol Neurosurg Psychiatry 1984;47:1223-31.
Pati S, Goodfellow JA, Hilton-Jones D. Approach to critical illness polyneuropathy and myopathy. Post Grad Med J 2008;84:354-60.
Khan J, Harrison TB, Rich MM, Moss M. Early development of critical illess myopathy and neuropathy in patients with sever sepsis. Neurology 2006;67:1421-5.
Leijten FS, de Weerd AW, Poortveit DC, De Ridder VA, Ulrich C. Critical illness polyneuropathy in multiorgan dysfunction syndrome and weaning from ventilator. Int Care Med 1996;22:856-61.
Garnacho-Montero-J, Madrazo-Osuna J, Garcia-Garmendia JL. Critical illness polyneuropathy: Risk factors and clinical consequences -A cohort study in septic patients. Int Care Med 1993;27:1288-96.
Bolton CF. Neuromuscular complications of sepsis. Int Care Med 1993;19:S58-63.
De Letter MA, Schmidtz PI, Visser FA, Verheul FA, Schellens RL, Op de Coul DA, et al. Risk factors for development of polyneuropathy and myopathy in critically ill patients. Crit Care Med 2001;29:2281-6.
Witt NJ, Zochodne DW, Bolton CF, Grand Maison F, Wells G, Young GB, et al. Peripheral nerve function in sepsis and multiple organ failure. Chest 1991;99:176-84.
Wiles CM. Neurological complications of severe illness and prolonged mechanical ventilation. Thorax 1996;51:S40-4.
Johnson KL. Neuromuscular complications in the intensive care unit-critical illness polyneuromyopathy. AACN Advanced Crit Care 2007;18:167-82.
Osler W. The Principles and Practice of Medicine. New York: D Appleton; 1892.
Mac Farlane IA, Resenthal FD. Severe myopathy after status asthmaticus. Lancet 1977;12:615.
Lefaucheur JP, Nordine T, Rodriguez P, Brochard L. Origin of ICU acquired paresis determined by direct muscle stimulation. J Neurol Neurosurg Psychiatry 2006;77:500-6.
Latronico N, Fenzi F, Recupero D, Guarneri B, Tomelleri G, Tonin P, et al. Critical illness myopathy and neuropathy. Lancet 1996;347:1579-82.
Koch S, Spuler S, Deja M, Bierbrauer J, Dimroth A, Behse F, et al. Critical illness myopathy is frequent: Accompanying neuropathy protracts ICU discharge. Neurol Neurosurg Psychiatry 2011;82:287-93
Hund E. Myopathy in critically ill patients. Crit Care Med 1999;27:2544-7.
Routsi C, Gerovasili V, Vasileiadis I, Karalzanos E, Pitsolis J, Tripodaki E. Electrical stimulation prevents critical illness polyneuromyopathy: A randomized parallel intervention trial. Crit Care 2010;14:274.
Gerovasili V, Stefanidis K, Vitzilaios K, Karalzanos E, Politis P, Koroneos A. Electrical muscle stimulation preserves the muscle mass of critical ill patients: A randomized study. Crit Care 2009;13:161.
Gruther W, Kainberger F, Failka- Moser V, Paternostro-Sluo T, Quittan M, Spiss C. Effects of neuromuscular electrical stimulation on muscle layer thickness of knee extensor muscles in intensive care unit patients: A pilot study. J Rehabil Med Preview 2010;42:593-7.
Bogie MK, Triolo JR. Effects of regular use of neuromuscular electrical stimulation on tissue health. J Rehabil Res Dev 2003;40:469-75.
Dal Corso S, Napolis L, Malaguti C, Gimenes AC, Alburquerque A, Nagueira CR. Skeletal muscle structure and function in response to electrical stimulation in moderately impaired COPD. Respir Med 2007;101:1236-43.
Deley G, Kervio G, Verges B, Hannequin A, Petitdant MF, Salmi-Belmihoub S, et al. Comparison of low frequency electrical myostimulation and conventional aerobic exercise training in patients with chronic heart failure. Eur J Cardiovasc Prev Rehabil 2005;12:226-33.
G Bourjeily-Habr, Rochester CL, Palermo F, Snyder P, Mohsenin V. Randomized control trial of tanscutanoeus electrical muscle stimulation of the lower extremities in patients with chronic obstructive pulmonary disease. Thorax 2002;57:1045-9.
Jesper B, Poulsen JB, Müller K, Jensen CV, Weisdorf S, Kehlet H, et al. Effect of transcutaneous electrical muscle stimulation on muscle volume in patients with septic shock. Crit Care Med 2011;39:456-61.
Herridge MS. Mobile, awake and critically ill. CMAJ 2008;178:725-6.
Pereira Da Silva A, Maynard K, Rodrigues Da Cruz M. Effects of motor physical therapy in critically ill patients. Rev Bras Ter Intensiva 2010;22:85-91.
Oates BR, Glover EI, West DW, Fry JL, Tarnopolsky MA, Phillips SM. Low volume resistance exercise attenuates the decline in strength and muscle mass associated with immobilization. Muscle Nerve 2010;42:539-46.
Little JP, Phillips SM. Resistance exercise and nutrition to counteract muscle wasting. Appl Physiol Nutr Metab 2009;34:817-28.
Ross G. A method for augmenting ventilation during ambulation. Phys Ther 1972;5:519-20.
Schweickert WD, Pohlman MC, Pohlman AS, Nigos C, Pawlik AJ, Esbrook CL, et al. Early physical and occupational therapy in mechanically ventilated, critically ill patients. Lancet 2009;373:1874-82.
Perme C, Chadrashekhar R. Early mobility and walking program for patients in intensive care units: Creating standard of care. Am J Crit Care 2009;18:12-221.
Bailey P, Thomsen GE, Sphuhler VJ, Blair R, Jewkes J, Bezdjian L, et al. Early activity is feasilble and safe in respiratory failure patients. Crit Care Med 2007;35:139-45.
Morris PE, Holbrook A, Thompson C, Ross A, Anderson L, Baker S, et al. A moblity protocol for acute respiratory failure patients delivered by an ICU mobility team shortened hospital stay. Crit Care Med 2006;34:A20.
Milbrandt EB. One small step for man.. Crit Care Med 2007;35:311-312.