An interventional study of Transcutaneous electrical stimulation and Magnetic stimulation in Muscle Weakness, sponsored by Centre Hospitalier Universitaire de Saint Etienne. Terminated at 1 site in France. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2024-11-15.
Sponsored by Centre Hospitalier Universitaire de Saint Etienne · Not applicable, Interventional, and Diagnostic
Acquired Neuromyopathy of Resuscitation (NMAR) is a common condition. Its diagnosis is difficult and often late because it is based on a clinical assessment of muscle strength (MRC score) requiring the patient to be awake and cooperative.
Transcutaneous electrical stimulation consists of applying electrical stimulation along the path of a motor nerve in order to generate contraction of the previously relaxed muscle. The mechanical response thus generated is recorded and allows the muscular strength developed to be assessed. Non-invasive and easily performed in the patient's bed, transcutaneous electrical stimulation could be an interesting alternative for early assessment of muscle strength in the still sedated resuscitation patient. However, this technique could be perceived as uncomfortable or painful in the awake patient so that magnetic stimulation, which is generally much better tolerated, should be preferred. However, magnetic stimulators have a limited maximum magnetic field which may prevent supramaximal stimulation especially in patients developing generalized edema (i.e., in the initial resuscitation phase).
We propose to conduct a reproducibility study of quadriceps force measurement in patients undergoing resuscitation by transcutaneous electrical and/or magnetic neurostimulation in the initial (i.e., \< 96 h) and late (> 96 h) phases of resuscitation and then in the recovery phase. For each investigative technique (i.e., electrical vs. magnetic), we will perform 2 types of stimulation: single stimulation and high frequency doublet stimulation (100 Hz), repeated 3 times each.
Exclusion Criteria:
Magnetic and Transcutaneous electrical stimulation of quadriceps
Diagnostic Test: Transcutaneous electrical stimulation · Diagnostic Test: Magnetic stimulation · Diagnostic Test: ultrasound measurement
The following tests and measurements will be carried out on the patient within 3 days of inclusion and again between the 4th and 6th day after inclusion and upon awakening: * three simple electrical stimulations, * three electrical doublets at the frequency of 100Hz For each type of electrical stimulation, the stimulations will be carried out 3 times and reproduced at 1 hour intervals.
The following tests and measurements will be carried out on the patient within 3 days of inclusion and again between the 4th and 6th day after inclusion and upon awakening: * three simple magnetic stimulations, * three magnetic doublets at the frequency of 100Hz For each type of magnetic stimulation, the stimulations will be carried out 3 times and reproduced at 1 hour intervals.
The ultrasound measurement of the thickness of the quadriceps muscle will be carried out on the patient within 3 days of inclusion and again between the 4th and 6th day after inclusion and upon awakening.
Reproductibility
Reproductibility of the force measurement after electrical muscle stimulation by a doublet at 100 Hz.
Time frame: At day 2
Reproductibility
Reproductibility of the force measurement after electrical muscle stimulation by a doublet at 100 Hz.
Time frame: At day 4
Reproductibility
Reproductibility of the force measurement after electrical muscle stimulation by a doublet at 100 Hz.
Time frame: when the patient wakes up (on average 15 days)
Reproductibility
Reproductibility of the force measurement after magnetic muscle stimulation by a doublet at 100 Hz.
Time frame: At day 2
Reproductibility
Reproductibility of the force measurement after magnetic muscle stimulation by a doublet at 100 Hz.
Time frame: At day 4
Reproductibility
Reproductibility of the force measurement after magnetic muscle stimulation by a doublet at 100 Hz.
Time frame: when the patient wakes up (on average 15 days)
Reproductibility
Reproductibility of the force measurement after one simple electrical muscle stimulation
Time frame: At day 2
Reproductibility
Reproductibility of the force measurement after one simple electrical muscle stimulation
Time frame: At day 4
Reproductibility
Reproductibility of the force measurement after one simple electrical muscle stimulation
Time frame: when the patient wakes up (on average 15 days)
Reproductibility
Reproductibility of the force measurement after one simple magnetic muscle stimulation
Time frame: At day 2
Reproductibility
Reproductibility of the force measurement after one simple magnetic muscle stimulation
Time frame: At day 4
Reproductibility
Reproductibility of the force measurement after one simple magnetic muscle stimulation
Time frame: At day 6
Intensive care unit acquired muscle weakness (ICUAW)
Occurrence of ICUAW defined by a MRC score less than 48
Time frame: 1 month
Plan to share: No
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Centre Hospitalier Universitaire de Saint Etienne