Effects of neuromuscular electrical stimulation on exercise capacity, muscle strength and quality of life in COPD patients: A Systematic Review with Meta-Analysis

Abstract

Objective To determine the effects of neuromuscular electrical stimulation on disabilities and activity limitation of individuals affected by chronic obstructive pulmonary disease. Data sources MEDLINE, PEDro database, Cochrane Controlled Trials Register, and SciELO, were searched from inception until October 2021. Review methods Inclusion criteria were patients with COPD, randomized controlled trials comparing neuromuscular electrical stimulation alone or combined conventional pulmonary rehabilitation and neuromuscular electrical stimulation versus control or sham or pulmonary rehabilitation in disabilities and activity limitation in COPD. There were no mandatory language or publication date restrictions. Two reviewers selected studies independently. Weighted mean differences and 95% confidence intervals were calculated. Results 32 studies met the study criteria, including 1.269 participants. Neuromuscular electrical stimulation improved exercise capacity (MD 1.10, 95% CI: 0.33, 1.86, N = 147), and muscle strength (0.53, 95% CI: 0.20, 0.87, N = 147) compared to sham group. Combined neuromuscular electrical stimulation and conventional rehabilitation improved exercise capacity (MD 34.28 meters, 95% CI: 6.84, 61.73, N = 262) compared to conventional rehabilitation alone. No adverse events were reported. Conclusions Neuromuscular electrical stimulation resulted in small improvement in disabilities and activity limitation (below the MCID) in COPD. Thus, the inclusion of neuromuscular electrical stimulation in rehabilitation programs must consider the cost Because of inadequate methodological conduction and reporting of methods, some studies were of low quality.

Effectiveness of neuromuscular electrical stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta‐analysis

“…Findings from this review suggest that NMES can be a valuable tool for maintaining limb muscle strength during acute exacerbations in patients with COPD, similar to results observed in patients with stable COPD (Alves al., 2022;Hill et al, 2018). Hospitalization due to acute exacerbations can lead to muscle weakness, physical function decline, and exercise capacity decline in patients with COPD (Carr et al, 2009;M.…”

“…Neuromuscular electrical stimulation (NMES) is a method used to improve physical function in PR. Some systematic reviews of patients with stable COPD have shown that NMES improves limb muscle strength, exercise capacity, and symptoms of dyspnea (Alves, da Silva E Silva, Martinez, de Queiroz, & Gomes-Neto, 2022;Hill et al, 2018); however, these studies have not focused on the acute exacerbation phase. Gutiérrez-Arias et al investigated the efficacy of NMES in patients with COPD on mechanical ventilatory management (Gutiérrez-Arias et al, 2022).…”

Effect of electromagnetic field therapy in chronic respiratory disease: systematic review

“…As a result, a specific therapy aimed at improving muscular strength is precisely in line with the peculiarities of CoPd and the demands of patients. Electrical muscle stimulation, on the other hand, is an effective method for preventing muscle atrophy in a variety of populations, including CoPd patients [28,29].…”

Impact of combined Russian current and threshold PEP on dyspnoea and functional capacity in patients with COPD: a randomised controlled trial

“…The application of Russian current to the expiratory muscles (abdominal muscles) causes phasic contraction, which improves diaphragm strength by forcing the ribs into an oblique and downward position. This gives the diaphragm a mechanical advantage, making contraction easier and decreasing inspiratory flux [21].…”