Neuromuscular electrical stimulation in addition to physical therapy prevents muscle atrophy after lung transplant surgery

SESSION TITLE: Transplantation Posters 2 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Poor outcomes in the early post-transplant period are thought to be caused by physical impairments associated with limb muscle dysfunction and deconditioning. Neuromuscular electrical stimulation (NMES) has emerged as a noninvasive means to enhance muscle mass and improve recovery in critically ill unable to actively participate in physical therapy but was not studied in the acute post-transplant setting. We developed a rehabilitation program that combines physical therapy with NMES and protein supplementation to prevent muscle atrophy and improve functional outcomes after lung transplant surgery. METHODS: The patients were randomized to either the treatment arm (n=5) or usual care (n=6) 72 hours after the transplant. Both groups of patients underwent an initial assessment of muscle strength measured by using a handheld dynamometer and lower extremity computer tomography (CT) evaluation within 72 hours post-transplantation. Patients in the treatment arm received additional physical therapy plus NMES (10 days) and nutrition supplementation during hospital recovery. Follow-up handheld dynamometer testing and lower extremity CT were performed 14 days post-transplant. RESULTS: Compared to the standard of care group, the treatment group decreased average ICU length of stay (5.80 vs 8.67 days) and decreased average hospital length of stay (16.8 vs 19.5 days). The treatment group had less decrease in muscle strength assessed by change in handgrip measurement. In addition, there were decreased changes in thigh muscle area in the intervention group vs the control group.The treatment group had less decrease in the muscle strength assessed by change in dominant hand handgrip measurement and thigh muscle area. Mean change between baseline and 14 day follow up in handgrip measurement were 2.8 in the intervention group and -0.8 in the control group. In addition, there were decreased changes in thigh muscle area in the intervention group vs control group. Although all patientsexperiends decrease in the thigh muscle area, the mean change in the intervention group (-16.5) was less than in the control group (-23.3). CONCLUSIONS: Combined physical therapy with neuromuscular electric stimulation (NMES) appears to be feasible and safe during the acute post-transplant period and may reduce muscle wasting and global muscle strength after the surgical procedure. CLINICAL IMPLICATIONS: The results can provide the foundation for developing a novel cardio thoracic rehabilitation program with the potential to improve outcomes of other cardiothoracic surgical procedures including heart transplants or CABG. DISCLOSURES: No disclosure on file for Srinivas Bollineni No relevant relationships by Lynn Huffman No disclosure on file for Aldo Iacono No relevant relationships by John Joerns No relevant relationships by Vaidehi Kaza No relevant relationships by Adrian Lawrence No disclosure on file for Larry Magder No relevant relationships by Luke Mahan No relevant relationships by Manish Mohanka No relevant relationships by Matthias Peltz No relevant relationships by Alice Ryan No relevant relationships by Michael Terrin No relevant relationships by Irina Timofte No relevant relationships by Fernando Torres No relevant relationships by Anu Varghese No relevant relationships by Avelino Verceles No relevant relationships by Michael Wait No relevant relationships by Chris Wells