Effectiveness of Neuromuscular Electrical Stimulation in Preventing Venous Thromboembolism: A Meta-Analysis Based on Randomized Controlled Trials

神经肌肉电刺激预防静脉血栓栓塞的有效性:基于随机对照试验的荟萃分析

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Abstract

ObjectivesThis study intended to investigate whether neuromuscular electrical stimulation(NMES) effectively prevents deep vein thrombosis(DVT) of lower limbs.MethodsMajor databases encompassing Pubmed, Embase, Web of Science, and Cochrane Library were thoroughly retrieved from their inception to January 1, 2025. Two reviewers separately selected studies, extracted data, and appraised the quality of eligible studies. Statistic analyses were executed leveraging Stata 15.0.ResultsA total of 599 studies were searched from databases. After literature screening,14 studies were included in our analysis. Meta-analysis revealed that NMES significantly increased peak venous velocity (PV) (mean difference [MD]) = 1.18, 95%CI: 0.93-1.43). Subgroup analyses confirmed significant improvements in PV across European and Asian populations, with the Geko device, Duo-STIM stimulator, 1 Hz stimulation, and common peroneal nerve stimulation (all P < 0.05). NMES also significantly enhanced ejected volume (EV) (MD = 0.90, 95%CI: 0.21-1.59) and time-averaged mean velocity (TAMEAN). Notably, the Irish subgroup, 36 Hz/1 Hz stimulation, and higher-intensity parameters (32 V voltage, 27 mA current) demonstrated significant efficacy for TAMEAN (all P < .05).All outcomes were statistically significant (P < .05).ConclusionsIn summary, NMES significantly improves the hemodynamics of the veins of lower limbs, though their effects are parameter-dependent and vary across regions. NMES can effectively improve PV, EV, and TAMEAN by optimizing device selection, targeting the common peroneal nerve, and adjusting stimulation parameters (1-36 Hz frequency, 27-32 V voltage).

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