Effect of external diaphragm pacing on pulmonary rehabilitation in stable chronic obstructive pulmonary disease patients

Abstract

Objective To assess the effect of external diaphragm pacing on pulmonary ventilation, arterial blood gas, exercise tolerance, and quality of life in patients with stable chronic obstructive pulmonary disease(COPD). Methods Screening out 34 patients with stable COPD who had been diagnosed in the Hunan Provincial People′s Hospital from January 2017 to February 2018 and who had been in stable condition and who had been prescribed according to the GOLD 2017 COPD Guidelines.Subgroups were divided according to the GOLD 2017 COPD Guideline Pulmonary Function Grading Criteria and Comprehensive Assessment Grouping criteria, all of which were treated with 20-day in external diaphragm pacing.Before and after external diaphragm pacing treatment, chronic obstructive pulmonary disease assessment test(CAT) scores and improved British Medical Research Council Breathing Difficulties Scale (mMRC) scores, pulmonary ventilation function tests, arterial blood gas analysis, the 6-minute walking distance (6MWD) were performed.Self-control analysis was used to evaluate the treatment effect. Results (1)Forced expiratory volume in the first second (FEV1) changes: there was no significant difference in FEV1 between the moderate group and the group B (t=1.78, 2.47, both P>0.05). The FEV1 in the severe group, the extremely severe group, the group C and the group D increased after treatment (t=6.81, 11.15, 3.07, 7.22, all P 0.05). The PaO2 in the extremely severe group and the group D increased after treatment (t=2.98, 3.08, both P 0.05). The mMRC scores in the severe group, the extremely severe group and the group D were lower than those before treatment (t=2.74, 3.00, 5.34, all P<0.05). Conclusions External diaphragm pacing treatment can improve the pulmonary ventilation function and arterial blood gas index in patients with COPD during stabilization, reduce the patient′s disease symptoms, and improve the patient′s exercise tolerance.And patients with severe impaired lung ventilation and severe symptoms benefit more. Key words: Pulmonary disease, chronic obstructive; Chronic electrical stimulation; Pulmonary rehabilitation; Diaphragmatic muscle