If Muscle Works, Use It! Potential Therapeutic Effects of Early Muscle Stimulation Through Exercise or Neuromuscular Electrical Stimulation in The Acute Phase of Endotoxic Shock

In this study, we demonstrated that neuromuscular electrical stimulation (NMES) exerts therapeutic effects under conditions, stimulation applied once at low frequency and low voltage or applied twice at low frequency and high voltage, that induce a mild switch in energy metabolism from glucose into lipid predominance through peroxisome proliferator-activated receptor gamma coactivator (PGC-1α) upregulation and suppression of inflammation and may be an effective early intervention even in hemodynamically unstable patients. In a previous study, we investigated changes in energy substrate utilization during sepsis and found that it changed from glucose to predominantly lipid utilization, with protein catabolism also increasing, as a function of sepsis severity. We had also demonstrated that low-intensity exercise in the acute phase of endotoxic shock has beneficial effects similar to those of NMES. These results suggest that upregulation of PGC-1α following exercise or NMES causes a metabolic switch from glucose to lipid utilization and suppresses inflammation, thereby improving the nutritional state and leading to a better outcome.


Takayuki Irahara, Norio Sato, Kosuke Otake, Satoru Murata, Kazuo Inoue, Kaoru Koike, Hiroyuki Yokota and Naoshi Takeyama

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