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Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients
Vieira PJC, Guntzel Chiappa AM, Cipriano G Jr, Umpierre D, Arena R, Chiappa GR
Respiratory Medicine 2014 Apr;108(4):609-620
clinical trial
4/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 = 9). 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-alpha) and beta-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-alpha and increased beta-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.

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