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Effects of quadriceps muscle neuromuscular electrical stimulation in living donor liver transplant recipients: phase-II single-blinded randomized controlled trial.

Hanada, M., Soyama, A. et al. (2019).

Clinical Rehabilitation; 33(5); 875-884.

To evaluate the efficacy of neuromuscular electrical stimulation on quadriceps muscle strength and thickness in liver transplantation patients.

The study group received bilateral quadriceps muscle electrical stimulation and the control group received bilateral tilialis anterior muscle stimulation. Neuromuscular electrical stimulation sessions were conducted for 30 minutes per session, once per day for five weekdays over four weeks by a physical therapist.

45 liver transplantation patients randomly assigned to quads group (n = 23) or the control group (n = 22).

Outcomes were assessed as quadriceps muscle strength, quadriceps muscle thickness and 6-minute walking distance.

Up to 90 days

CET Conclusions
This small single-centre study investigates the role of passive electrical stimulation of the quadriceps muscle post-transplant in liver recipients. The authors find a reduction in post-transplant quadriceps muscle loss (measured by muscle thickness) in the study group when compared to controls, but with no difference in strength or walking distance. The study design is robust, with blinded outcome assessment and allocation concealment. The control group received stimulation of the tibialis anterior muscle, which may have affected some outcomes (e.g. 6-minute walk test) and therefore reduced any effect size seen in these outcomes. Despite a small initial sample size (45 patients), over 30% patients were lost to final follow-up in each group, limiting the final power. Ultimately, larger studies will be required to see if the benefits seen here translate into any meaningful clinical effect.

Jadad score

Data analysis
Strict intention-to-treat analysis

Allocation concealment

Trial registration
UMIN-CTR - UMIN000011655

Funding source
No funding received