The Acute Effects of Neuromuscular Electrical Stimulation on Coagulation and Cardiovascular Factors

Neuromuscular electrical stimulation (NMES) can potentially be used to prevent venous thromboembolism, however, its impact on coagulation-related factors remains poorly understood. We aimed to investigate the acute effects on coagulation- and cardiovascular factors immediately after a 2-hour NMES-session. Levels of Overall Hemostatic Potential (OHP), fibrinogen, factor VIII and Olink proteomic cardiovascular factors were assessed before and after the NMES-session in 36 healthy participants (20 males, 16 females) with a mean age of 31.9 years. NMES was administered using integrated textile electrodes in pants (NMES-pants). Mean intensities during the quadriceps, hamstrings, and gluteus muscle stimulation were 16.5, 20.5 and 25.4mA, respectively, corresponding to submaximal intensity levels with acceptable discomfort (just below 4 on the visual analogue scale [VAS], 0-10). The NMES-session resulted in a significant increase in mean (SD) OHP (94.4(28.3) to 103(31.0)), and Overall Coagulation Potential (292(50.4) to 307(49.8)), and a decrease in Overall Fibrinolytic Potential (68.2(5.46) to 67.1(5.20)). These changes were highly correlated with the increase in fibrinogen (all R>0.7, p<=0.001), but not with the increase in factor VIII. Additionally, 18 of 92 cardiovascular proteins, specifically those involved in regulating inflammation and extracellular matrix remodeling, were influenced by NMES; however, low correlations were found between the changes in these proteins and OHP-analyses. In conclusion, the NMES-session resulted in a slight increase in the coagulative state, mirroring that seen after a bout of regular exercise. The changes observed in cardiovascular factors, which are mostly not directly related to coagulation, suggests that NMES may subsequently modulate inflammatory responses, warranting further investigation.