Cochrane Database of Systematic Reviews, 2017 · DOI: 10.1002/14651858.CD011764.pub2 · Published: November 1, 2017
Venous thromboembolism (VTE), the formation of unwanted blood clots in the deep veins of the legs, is a serious health problem that can be prevented by pharmacological or mechanical methods. Neuromuscular electrical stimulation (NMES) is a mechanical method that delivers electrical impulses to induce muscle contraction. This review compared NMES with no treatment or other methods like low-dose heparin and compression stockings for preventing blood clots. The review included eight studies enrolling a total of 904 participants. The review found no clear difference in the risk of unwanted blood clots in the legs between NMES and alternative methods, but NMES was associated with a lower risk compared to no treatment, and a higher risk compared to heparin. However, the quality of evidence was generally low, and more studies are needed to strengthen the evidence.
Low-quality evidence suggests no clear differences in DVT risk between NMES and alternative prophylaxis, but moderate-quality evidence indicates NMES may lower DVT risk compared to no prophylaxis. Low-quality evidence suggests higher DVT risk with NMES compared to low-dose heparin.
Adequately powered RCTs are needed to provide robust evidence on the effectiveness of NMES versus other methods, additional effects of NMES combined with other methods, and cost-effectiveness of NMES.
Research is needed to determine the most effective NMES device and setting for delivery, as well as identify patient populations that may benefit most from NMES for VTE prophylaxis.