Effects of neuromuscular electrical stimulation on recovery in intensive care units: An umbrella review

Abstract

Aim: The aim of this umbrella review was to synthesise existing evidence from systematic reviews on the impact of neuromuscular electrical stimulation on recovery in intensive care units. Methods: This umbrella review was conducted in accordance with the Joanna Briggs Institute methodological guidance, and its reporting followed the Preferred Reporting Items for Overviews of Reviews statement. The search was carried out in the databases Medline®, CINAHL®, Scopus®, SciELO®, Web of Science®, Cochrane®, and SportDiscus®, using both indexed terms specific to each database and free-text terms. To assess the methodological quality of the included systematic reviews, the AMSTAR 2, tool was usedcovering 16 domains related to review design and reporting quality. The search was conducted with no temporal limits, until December 2024. Results: A total of 21 systematic reviews were included. The most frequently assessed outcomes were muscle strength, muscle mass, and duration of mechanical ventilation. Muscle strength was the most extensively investigated outcome, with 11 reviews reporting positive effects. The analysis of primary study overlap revealed a moderate degree of overlap (6.71%). Conclusion: It is concluded that neuromuscular electrical stimulation is safe for critically ill patients, with positive effects on muscle strength, muscle mass, and the duration of mechanical ventilation. Although neuromuscular electrical stimulation demonstrates promising results in the rehabilitation of critically ill patients, the methodological quality of the available systematic reviews is variable. Therefore, there is a need for more robust and high-quality systematic reviews to strengthen the evidence base.