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Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients.
Respir Med. 2014 Apr; 108(4):609-20.RM

Abstract

BACKGROUND

Neuromuscular electrical stimulation (NMES) improves muscle performance and exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. In contrast, no study has assessed the effect of NMES on dynamic hyperinflation (DH) in COPD. This study investigated the effect of short-term, high-frequency NMES on DH in patients with COPD.

METHODS

Twenty patients were randomly allocated to either a NMES applied bilaterally to the quadriceps muscles (n = 11: 8 weeks, 5 days/week, twice/day, 45 min/session) or a control group (n = 09). All patients received respiratory physical therapy and stretching exercises. Free fat mass, pulmonary function, time to exercise tolerance (Tlim), 6-min walk test distance (6-MWTD), tumor necrosis factor (TNF-α) and β-endorphin levels, Borg dyspnea and leg score (BDS and BLS) and quality of life by the St. George's Respiratory Questionnaire score (SGRQ) were examined before and after the intervention.

RESULTS

Compared with the control group, NMES increased FEV1 and FEV1/FVC, 6-MWD and Tlim (P < 0.01) and reduced BDS and SGRQ (P < 0.01). Additionally, changes in the Tlim were positively correlated with respiratory improvements in FEV1 (rho = 0.48, P < 0.01). Also, NMES reduced TNF-α and increased β-endorphin levels, compared with the control group (P < 0.001).

CONCLUSION

In summary, 8 weeks of NMES promotes reduction of the perceived sensation of dyspnea during exercise in patients with COPD. This finding is accompanied by improvements in FEV1, exercise tolerance and quality of life, and DH. Interestingly, these findings may be associated with enhanced vasodilatory function and a reduction in inflammatory responses.

CLINICAL TRIAL REGISTRATION

NCT01695421.

Authors+Show Affiliations

Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.Physical Therapy Division and Intensive Care Unit from Hospital de Clínicas de Porto Alegre, Brazil.Physical Therapy Division, University of Brasilia, Brasília, Brazil.Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil; Serra Gaucha College, Physical Therapy Division, Brazil. Electronic address: gchiappa@hcpa.ufrgs.br.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24418570

Citation

Vieira, Paulo J C., et al. "Neuromuscular Electrical Stimulation Improves Clinical and Physiological Function in COPD Patients." Respiratory Medicine, vol. 108, no. 4, 2014, pp. 609-20.
Vieira PJ, Chiappa AM, Cipriano G, et al. Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respir Med. 2014;108(4):609-20.
Vieira, P. J., Chiappa, A. M., Cipriano, G., Umpierre, D., Arena, R., & Chiappa, G. R. (2014). Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respiratory Medicine, 108(4), 609-20. https://doi.org/10.1016/j.rmed.2013.12.013
Vieira PJ, et al. Neuromuscular Electrical Stimulation Improves Clinical and Physiological Function in COPD Patients. Respir Med. 2014;108(4):609-20. PubMed PMID: 24418570.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. AU - Vieira,Paulo J C, AU - Chiappa,Adriana M Güntzel, AU - Cipriano,Gerson,Jr AU - Umpierre,Daniel, AU - Arena,Ross, AU - Chiappa,Gaspar R, Y1 - 2014/01/02/ PY - 2013/08/18/received PY - 2013/12/19/revised PY - 2013/12/20/accepted PY - 2014/1/15/entrez PY - 2014/1/15/pubmed PY - 2014/12/15/medline KW - Body composition KW - Dynamic hyperinflation KW - Dyspnea KW - Electrical stimulation KW - Exertion KW - Pulmonary rehabilitation SP - 609 EP - 20 JF - Respiratory medicine JO - Respir Med VL - 108 IS - 4 N2 - BACKGROUND: Neuromuscular electrical stimulation (NMES) improves muscle performance and exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. In contrast, no study has assessed the effect of NMES on dynamic hyperinflation (DH) in COPD. This study investigated the effect of short-term, high-frequency NMES on DH in patients with COPD. METHODS: Twenty patients were randomly allocated to either a NMES applied bilaterally to the quadriceps muscles (n = 11: 8 weeks, 5 days/week, twice/day, 45 min/session) or a control group (n = 09). All patients received respiratory physical therapy and stretching exercises. Free fat mass, pulmonary function, time to exercise tolerance (Tlim), 6-min walk test distance (6-MWTD), tumor necrosis factor (TNF-α) and β-endorphin levels, Borg dyspnea and leg score (BDS and BLS) and quality of life by the St. George's Respiratory Questionnaire score (SGRQ) were examined before and after the intervention. RESULTS: Compared with the control group, NMES increased FEV1 and FEV1/FVC, 6-MWD and Tlim (P < 0.01) and reduced BDS and SGRQ (P < 0.01). Additionally, changes in the Tlim were positively correlated with respiratory improvements in FEV1 (rho = 0.48, P < 0.01). Also, NMES reduced TNF-α and increased β-endorphin levels, compared with the control group (P < 0.001). CONCLUSION: In summary, 8 weeks of NMES promotes reduction of the perceived sensation of dyspnea during exercise in patients with COPD. This finding is accompanied by improvements in FEV1, exercise tolerance and quality of life, and DH. Interestingly, these findings may be associated with enhanced vasodilatory function and a reduction in inflammatory responses. CLINICAL TRIAL REGISTRATION: NCT01695421. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/24418570/Neuromuscular_electrical_stimulation_improves_clinical_and_physiological_function_in_COPD_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(13)00499-X DB - PRIME DP - Unbound Medicine ER -