Table 4

Summary of findings; intervention: NMES

WHO domain outcomeReview author;
N studies: N patients
Pooled effect (95% CI)GRADE of evidenceExplanation
Muscle strengthWageck et al27
SMD 0.77, (0.13 to 1.40), p=0.02ϴ
Very low*
Downgraded −3 for serious risk of bias, inconsistency and imprecision
Muscle structureWageck et al27
Not possible to poolϴϴ
Downgraded −2 for serious inconsistency and indirectness
CIP/CIMHermans et al25
RR 0.32 (0.10 to 1.01), p=0.05ϴϴ
Downgraded −2 for serious risk of bias and indirectness
  • Comparison: usual care. Stage of recovery: in the ICU.

  • *50% no concealed allocation; 50% no blinded assessors; 50% not reported measures of key outcomes >85% patients; 50% no ITT and mean difference in one study does not fall within the 95% CI of the other.

  • Three studies reported an effect and three did not; and different outcome measures were used at different timepoints.

  • High ROB reported by review for this study vis-à-vis randomisation, concealment, incomplete outcome data and selective reporting; and not all participants were evaluable.CIP/CIM, critical illness polyneuropathy/myopathy; ICU, intensive care unit; ITT, intention to treat; NMES, neuromuscular electrical stimulation; ROB, risk of bias; RR, risk ratio; SMD, standard mean difference.