INTRODUCTION: Pulmonary rehabilitation is an effective intervention for individuals who have chronic obstructive pulmonary disease (COPD). The adequate intensity, components, and number of sessions are difficult to determine, specifically in patients who have severe ventilatory limitations in order to produce true physiological training effects without adverse events. OBJECTIVE: Our aim is to assess the feasibility and possible effects of a daily versus a twice-daily functional electrostimulation program in hospitalized individuals who have a severe COPD. METHODS: In this randomized controlled trial, 48 severe patients with COPD were randomized into three groups: control group (CG; n = 16), daily functional electrostimulation group (DFEG; n = 15) or twice-daily functional electrostimulation group (TFEG; n = 17). The main outcome measures were quadriceps strength, symptoms at rest and after exercise, and adverse events measured before and after the intervention. RESULTS: After eight sessions, DFEG and TFEG showed significant differences when compared to the CG in all measured variables at discharge (p <= 0.001), no adverse events were observed in any of the treatment groups. Significant improvements were found in strength (p <= 0.05) between DFEG and TFEG groups. However, lower limb function did not present significant differences in spite of the fact that the mean change favored the TFEG (23.53 +/- 3.53 versus 19.56 +/- 11.89). CONCLUSION: Further examination of twice per day functional electrostimulation in hospitalized patients with COPD with acute exacerbation appears warranted.

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