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ORIGINAL RESEARCH
Electrical myostimulation effects on neuromuscular conduction and functional state of muscles after component separation
1 Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
2 Pirogov Russian National Research Medical University (Pirogov University), Moscow, Russia
3 Patrice Lumumba Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
Correspondence should be addressed: Oleg E. Ostanin
Ostrovityanova, 1, Moscow, 117513, Russia; ur.xednay@1102gelo.ninatso
Author contribution: Demin NA — implementation of the main stages of the pilot study, manuscript writing; Achkasov EE — study design, academic editing, expert control; Polyaev BA — academic editing, expert control; Shishkin AA — statistical data processing; Medvedeva AI — manuscript writing, clinical data collection; Ostanin OE — clinical data collection, statistical processing.
Compliance with ethical standards: the study was approved by the Ethics Committee of the Sechenov University (protocol No. 08-19 dated 05 June 2019). All subjects submitted the informed consent. No personally identifiable information is disclosed.
Muscular dysfunction of the anterior abdominal wall persists in many patients post component separation due to postoperative ventral hernia. Electrical myostimulation can contribute to better recovery, but its efficacy after such surgical procedures is poorly understood. The study aimed to assess the effect of the postoperative electrical myostimulation on the neuromuscular conduction and functional activity of the rectus abdominis muscles. A total of 128 patients (average age 47.9 ± 8.6 years) post component separation were included in a prospective controlled non-randomized study. The index group (n = 64) received electrical myostimulation starting from day 10 (12 sessions, 5–10 min each, 3 times a week, COMPEX SP-2.0® muscle stimulator, Switzerland), and the control one (n = 64) received no electrical myostimulation. Electroneuromyography of the rectus abdominis muscles was performed before and after the course using the Synapsis system (Neurotech, Russia). In the index group, the latency period reduced from 10.1 to 7.9 ms (by 21.8%; p < 0.001), and in the control group it reduced from 9.7 to 9.2 ms (by 5.2%; p < 0.001); the intergroup difference p = 0.002. The M-response amplitude improved in both groups (index group: from 8.4 to 8.9 mV, +5.6%, p < 0.001; control group: from 8.2 to 8.8 mV, +6.8%, p < 0.001), without any intergroup differences (p = 0.295). The induced muscle contraction velocity changed minimally in the index group (from 45.0 to 45.4 m/s, p = 0.049) and did not change in the control group (p = 0.316); in 89.1% of patients, the values were still below normal. Conclusions: postoperative electrical myostimulation significantly accelerates the neuromuscular conduction restoration, but does not affect the muscular response amplitude. It is reasonable to include electrical myostimulation in rehabilitation programmes.
Keywords: electrical myostimulation, postoperative rehabilitation, ventral hernia, hernioplasty, neuromuscular conduction, electroneuromyography