Key result
Neuromuscular electrical stimulation plus PR increases 6MWD by ~61 meters over PR alone in moderate COPD.
Why the study?
The effects of neuromuscular electrical stimulation combined with pulmonary rehabilitation in patients with moderately impaired COPD were not well established.
Does neuromuscular electrical stimulation added to pulmonary rehabilitation improve quadriceps strength and exercise capacity in patients with moderate COPD?
RCT (n=83)
Double-blind
Stratified randomization
No
Does neuromuscular electrical stimulation added to pulmonary rehabilitation improve quadriceps strength and exercise capacity in patients with moderate COPD?
Absolute Event Rate: 146.4% vs 85.3%
p-value: p=0.005
Adding neuromuscular electrical stimulation to pulmonary rehabilitation significantly improves quadriceps strength and exercise capacity in patients with moderate COPD compared to pulmonary rehabilitation alone.
Supports adding neuromuscular electrical stimulation to pulmonary rehabilitation in moderate COPD; extends evidence for adjunctive therapies targeting exercise capacity.
Aims: Effectiveness of combination of pulmonary rehabilitation (PR) and neuromuscular electrical stimulation (NMPR) in severe chronic obstructive pulmonary disease (COPD) is well established.We verified the effects of NMPR compared with pulmonary rehabilitation and sham stimulation (SSPR) in patients with moderately impaired COPD.Methods: Quadriceps strength (sit-to-stand test: STST) and exercise capacity (6 minute walking test: 6MWT) were considered primary outcomes.Lung function, dyspnoea (modified Medical Research Council: mMRC) and quality of life (St.George's Respiratory Questionnaire: SGRQ) secondary outcomes.Results: 83 stable patients in stage II, moderate COPD (23 female; mean age, 61.7 ± 9.1 years; FEV 1 59.8 ± 7.3% of predicted) were enrolled.Quadriceps strength was enhanced by SSPR (STST + 7±1.7 repetitions; p≤0.001);NMPR further increased strength (+10±1.6 repetitions; p≤0.001) with a significant difference (p≤0.05) between the treatments.SSPR significantly increased exercise capacity (6MWD + 85.3±11.5 m; p=0.01);NMPR further increased the distance walked (6MWD +146.4±32.7 m; p=0.01) with a significant difference (p≤0.05) between the treatments.None of the two treatments influenced lung function.Quality of life score (SGRQ -8.3±2.1;p=0.01) and dyspnoea score (mMRC-0.7±0.18;p=0.01) decreased after SSPR suggesting a positive effect.NMPR did not further improve the score.Conclusions: This study confirms that PR is able to ameliorate quadriceps strength, exercise capacity, quality of life and dyspnoea in moderately impaired COPD patients.NMPR may further improve quadriceps strength and exercise capacity with respect to PR alone.
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Zanotti et al. (2012) conducted an RCT in Moderate Chronic Obstructive Pulmonary Disease (COPD) (n=83). Neuromuscular electrical stimulation (NMES) and pulmonary rehabilitation vs. Sham stimulation and pulmonary rehabilitation was evaluated on Change in 6-minute walk distance (meters) (p=0.005). The combination of neuromuscular electrical stimulation and pulmonary rehabilitation significantly improved 6-minute walk distance by 146.4 meters compared to an 85.3 meter increase with pulmonary rehabilitation alone in patients with moderate COPD.
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