{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T07:12:17Z","timestamp":1788419537860,"version":"build-2803163510"},"reference-count":58,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Physiotherapy Canada"],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Purpose:<\/jats:italic>\n                    <\/jats:bold>\n                    Neuromuscular electrical stimulation (NMES) may be used to prevent ICU-acquired weakness. Heart rate variability (HRV), mechanomyography (MMG), and pain objectively assess patient experience and muscle response during NMES, which may facilitate its delivery in non-responsive patients. This study investigated the associations between the secondary outcomes of MMG and HRV with the primary outcomes, quality of contraction (QoC), and pain during NMES.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Method:<\/jats:italic>\n                    <\/jats:bold>\n                    Using a cross-sectional design, an NMES protocol supervised remotely was delivered to the tibialis anterior muscle in 12 healthy participants. Data on MMG assessed using accelerometry, HRV using photoplethysmography, QoC using a modified version of the MRC scale, and self-reported pain using a numeric pain rating scale (NPRS) were collected. A Spearman rank-order correlation was used to determine associations between MMG and NPRS\/QoC and between HRV and NPRS\/QoC.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Results:<\/jats:italic>\n                    <\/jats:bold>\n                    Positive correlations were found between MMG and NPRS scores, and between MMG and QoC. No significant correlations were observed between HRV and NPRS scores, and between HRV and QoC.\n                    <jats:bold>\n                      <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic>\n                    <\/jats:bold>\n                    MMG, but not HRV, is useful for assessing muscle QoC and pain during NMES. Findings from this study may help guide selection of variables to use in delivery of NMES in non-responsive patients. Further studies with larger sample sizes of non-responsive patients should be explored.\n                  <\/jats:p>","DOI":"10.3138\/ptc-2023-0111","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T04:10:57Z","timestamp":1786162257000},"page":"308-319","source":"Crossref","is-referenced-by-count":0,"title":["Can Mechanomyography and Heart Rate Be Used to Guide Neuromuscular Electrical Stimulation Delivery in the Non-Responsive Patient? A Cross-Sectional Study in Healthy Adults"],"prefix":"10.3138","volume":"78","author":[{"given":"Nicholas","family":"Markakos","sequence":"first","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5507-8333","authenticated-orcid":true,"given":"Brittany","family":"Wu","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6632-9413","authenticated-orcid":true,"given":"Deor","family":"Bektashi","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Campbell","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Dasouki","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana Juan","family":"Ding","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5564-9796","authenticated-orcid":true,"given":"Sunita","family":"Mathur","sequence":"additional","affiliation":[{"name":"School of Rehabilitation Therapy, Queen\u2019s University, Kingston, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7015-189X","authenticated-orcid":true,"given":"Jane","family":"Batt","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada;"},{"name":"St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3033-5675","authenticated-orcid":true,"given":"Maryam","family":"Davoudpour","sequence":"additional","affiliation":[{"name":"Faculty of Applied Science and Technology, Humber College, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vlad","family":"Porcila","sequence":"additional","affiliation":[{"name":"Faculty of Applied Science and Technology, Humber College, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7889-3772","authenticated-orcid":true,"given":"Alireza","family":"Sadeghian","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Toronto Metropolitan University, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1932-2797","authenticated-orcid":true,"given":"Adriana","family":"Ieraci","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Toronto Metropolitan University, Toronto, Ontario, Canada;"},{"name":"Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5202-3736","authenticated-orcid":true,"given":"Sharon","family":"Gabison","sequence":"additional","affiliation":[{"name":"From the: Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1696","reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"crossref","DOI":"10.12688\/f1000research.17376.1","article-title":"Intensive care unit\u2013acquired weakness: unanswered questions and targets for future research","volume":"8","author":"Piva S","year":"2019","unstructured":"Piva S, Fagoni N, Latronico N. 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