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Neuromuscular electrical stimulation, muscle mass, and physical function decline in the early phase after living donor liver transplantation

医学 体质指数 骨骼肌 康复 刺激 肝移植 移植 肌萎缩 物理疗法 内科学 外科
作者
Yuji Yoshioka,Yohei Oshima,Susumu Satō,Akira Tamaki,Ryota Hamada,Junsuke Miyasaka,Koichiro Hata,Takashi Ito,Ryosuke Ikeguchi,Etsuro Hatano,Shuichi Matsuda
出处
期刊:Liver Transplantation [Wiley]
卷期号:30 (12): 1264-1272
标识
DOI:10.1097/lvt.0000000000000408
摘要

This study aims to investigate the effects of neuromuscular electrical stimulation (NMES) in addition to conventional early mobilization in the early postoperative period after living donor liver transplantation (LTx) on body composition and physical function. This was a retrospective single-center cohort study. Adult subjects who were admitted for living donor LTx from 2018 to 2023 were included in the analysis. After April 2020, patients underwent 4 weeks of NMES in addition to conventional rehabilitation. The skeletal muscle mass index, body cell mass, and physical function, including the 6-minute walking distance, were assessed before surgery and at discharge, and changes in these outcomes were compared before and after the introduction of NMES. Sixty-one patients were in the NMES group, and 53 patients before the introduction of NMES were in the control group. ANCOVA with etiology, obstructive ventilatory impairment, Child-Pugh classification, and initial body composition value as covariates demonstrated that there was a significantly smaller decline of body cell mass (−2.9±2.7 kg vs. −4.4±2.7 kg, p = 0.01), as well as of the skeletal muscle mass index (−0.78±0.73 kg/m 2 vs. −1.29±1.21 kg/m 2 , p = 0.04), from baseline to discharge in the NMES group than in the control group; thus, the decline after surgery was suppressed in the NMES group. Four weeks of NMES, in addition to conventional rehabilitation in the early period after LTx, may attenuate the deterioration of muscle mass. It is suggested that NMES is an option for developing optimized rehabilitation programs in the acute postoperative period after LTx.
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