Neuromuscular electrostimulation as an adjuvant therapy to pulmonary rehabilitation programs in chronic obstructive pulmonary disease

Abstract

Introduction. Chronic obstructive pulmonary disease (COPD) is commonly associated with a vicious circle of sedentary lifestyle - deconditioning - muscular dysfunction. High-frequency neuromuscular electrostimulation has demonstrated beneficial effects among subjects with muscle weakness. This study aimed to evaluate the benefits of merging pulmonary rehabilitation program (PRP) with neuromuscular electrostimulation in patients with very severe COPD. Material and methods. The study included 38 males with clinically stable COPD, who were divided in 2 groups: group A-19 patients that underwent a PRP of 5 sessions/week for 4 weeks and group B-19 patients that underwent intercostal and lower extremity muscle electrostimulation (5 sessions/week for 4 weeks, 60 min /session) in association with the same type of PRP. Saint Georges’s Respiratory Questionnaire (SGRQ), Modified Medical Research Council (mMRC) dyspnea scale, spirometry, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax), six minutes walking test (6MWT) and bio-electrical impedance were examined before and after the intervention. Results. Electrostimulation applied in group B increased muscle mass (50.15 ± 0.61kg vs 53.97 ± 0.87kg, p<0.001)., PEmax (5.41 ± 0.25 vs post 6.79 ± 0.22, p<0.0003) and improved mMRC score (2.68 ± 0.15 vs 2.10 ± 0.15, p<0.0109), 6MWT (369.6 ± 10.77m vs post: 445.6 ± 6.03 m) and SGRQ (61.32 ± 1.83 vs. 44.95 ± 1.94, p<0.0001). In group B only SGRQ score (55.05 ± 1.32 vs. 50.05 ± 1.51, p=0.018) was improved after PRP. Conclusion. A protocol which combines PRP with neuromuscular electrical stimulation in patients with very severe forms of COPD, has grater beneficial effect on dyspnoea, exercise tolerance, muscle mass toning and quality of life, compared with PRP alone.

Effect of transcutaneous electrical nerve stimulation of acupoints on respiratory outcomes of COVID‐19 patients with moderate pulmonary involvement: A parallel randomized clinical trial

“…Likewise, Öncü and Zincir 19 concluded that Acu‐TENS intervention does not affect dyspnea in patients with COPD in the acute exacerbation phase. However, previous studies on patients with COPD and asthma confirmed a reduction in the severity of dyspnea after Acu‐TENS intervention 15–18 . It should be noted that the present study was performed on hospitalized patients who were in the acute phase of the disease, which is similar to the study by Öncü and Zincir 19 .…”

“…However, previous studies on patients with COPD and asthma confirmed a reduction in the severity of dyspnea after Acu‐TENS intervention. 15 , 16 , 17 , 18 It should be noted that the present study was performed on hospitalized patients who were in the acute phase of the disease, which is similar to the study by Öncü and Zincir. 19 Dyspnea is a mental feeling affected by conditions such as weakness, anemia, lack of sleep, fatigue, fear, and anxiety, 28 and physically healthy people may have experienced dyspnea.…”

“…In the Acu‐TENS group, a trained physiotherapist identified the acupuncture point EX‐B1 (Located on both sides of the spinous process of the seventh cervical vertebra); this point has been used in various studies to manage respiratory symptoms. 14 , 15 , 16 , 17 , 18 Then, the physiotherapist connected two 5 × 5 cm plastic electrodes at the EX‐B1 acupuncture point, and the electrodes were related to the NOVIN 701 P PLUS‐STIMULATOR (Iranian manufacturer and serial number AX212088). Next, an electric current with a pulse of 200 microseconds and a frequency of 4 Hz Acu‐TENS was applied at the point for 45 min 25 for four consecutive days.…”

“…13 For example, in studies on the respiratory outcomes of patients with lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma, the effectiveness of this method has been reported in improving the respiratory symptoms and respiratory capacity of patients. [14][15][16][17][18] However, Öncü and Zincir found that applying Acu-TENS in patients with COPD in the acute exacerbation phase does not affect respiratory parameters. 19 It is noteworthy that respiratory diseases have different conditions, and there are possible differences in the effectiveness of the Acu-TENS method on the respiratory conditions of patients.…”

“…As one of the most modern methods based on acupuncture, this technique has been employed in several studies 13 . For example, in studies on the respiratory outcomes of patients with lung diseases, including chronic obstructive pulmonary disease (COPD) and asthma, the effectiveness of this method has been reported in improving the respiratory symptoms and respiratory capacity of patients 14–18 . However, Öncü and Zincir found that applying Acu‐TENS in patients with COPD in the acute exacerbation phase does not affect respiratory parameters 19 .…”