Masanori Kamiue, MS, Akio Tsubahara, MD, DMSC, Tomotaka Ito, PhD
Jpn J Compr Rehabil Sci 15: 27-33, 2024
Introduction: A patient developed severe lower limb
muscle weakness and gait disturbance after receiving
mechanical ventilation in the intensive care unit (ICU)
due to coronavirus disease 2019 (COVID-19). We
describe the effect of repetitive peripheral magnetic
stimulation (rPMS) to strengthen his lower limb
muscles.
Case: A 70-year-old man was mechanically ventilated
due to COVID-19-related breathing difficulties. He
was weaned off mechanical ventilation after 54 days,
and the tracheostomy was closed after 225 days.
However, his lower limbs remained significantly
weak, and he was wheelchair-bound for daily
activities. Despite approximately 6 months of
functional training at a day-service center, his physical
function and movement abilities did not improve.
Therefore, 30-Hz rPMS was applied to both quadriceps
for 20 minutes/day, three times a week, for 4 weeks
(12 times). Knee extensor torque (KET) during
maximum voluntary contraction (MVC) was greater
after (right: 42.1 Nm, left: 40.7 Nm) than before the
intervention (right: 33.7 Nm, left: 36.2 Nm). Before
the intervention, KET induced by rPMS (rPMSinduced
torque) was 0 Nm on both sides, the 30-second
chair stand test (CS-30) was challenging to perform,
and the walking item score of the Functional
Independence Measure (FIM) was 2 points (endurance
30 m). Post-intervention, rPMS-induced torque was
6.5 Nm on the right and 4.7 Nm on the left side, CS-30
could be performed once, and the FIM walking score
was improved to 6 points (endurance 60 m).
Discussion: The use of rPMS improved lower limb
muscle strength in a patient who developed ICUacquired
muscle weakness after COVID-19.
Key words: repetitive peripheral magnetic stimulation, skeletal muscle, peripheral nerve, muscle strengthening, COVID-19