Clinical Research Directory

NMES will be applied bilaterally to the quadriceps femoris muscles (rectus femoris and vastus intermedius) for 30 minutes daily for one week. Stimulation parameters will include a frequency of 50 pulses per second, pulse duration of 1000 microseconds, ramp time of 5 seconds, and a duty cycle of 1:5. Two rectangular carbon electrodes (6 × 8 cm) will be placed over the motor points of the targeted muscles. Patients will be positioned in supine lying with approximately 40 degrees knee flexion. In addition, participants will receive a conventional physiotherapy program twice daily, including passive and active-assisted range of motion exercises, early mobilization, bed mobility, sitting, standing, and ambulation.

Participants in this group will receive a conventional physiotherapy program only during extracorporeal membrane oxygenation (ECMO) support. The program will be administered twice daily for one week. The intervention will include early mobilization strategies starting with passive range of motion exercises and progressing to active-assisted and active exercises as tolerated. Rehabilitation activities will include bed mobility, sitting at the edge of the bed, bedside standing, and assisted ambulation according to patient tolerance and clinical stability. All interventions will be delivered according to standard ICU physiotherapy practices. Neuromuscular electrical stimulation (NMES) will not be applied in this group.