Effects of repetitive peripheral magnetic stimulation on a patient with severe lower limb muscle weakness due to coronavirus disease-2019.

Kamiue M, Tsubahara A, Ito T. Effects of repetitive peripheral magnetic stimulation on a patient with severe lower limb muscle weakness due to coronavirus disease-2019. Jpn J Compr Rehabil Sci 2024; 15: 27-33. 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 (rPMS-induced 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 ICU-acquired muscle weakness after COVID-19.