The Effect of Adding Neuromuscular Electrical Stimulation with Endurance and Resistance Training on Exercise Capacity and Balance in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial.

Amal Acheche,Zouhair Tabka,Pierachille Santus,Marwa Mekki,Yassine Trabelsi,Thierry Paillard

doi:10.1155/2020/9826084

Abstract

This study investigated the effectiveness of adding neuromuscular electrical stimulation (NMES) to endurance training (ET) and resistance training (RT) on exercise tolerance and balance in COPD patients. 42 patients were assigned randomly to the ET + RT + NMES group (n = 22) or ET + RT group (n = 20). Two training programs were performed including 72 sessions. The center of pressure (CoP) displacement in the mediolateral direction (CoPML), in the anteroposterior direction (CoPAP), and the center of pressure velocity (CoPV) were recorded using a stabilometric platform with eyes open (EO) and eyes closed (EC). Time up and go and Berg Balance Scale tests, 6-minute walking test (6MWT), and the maximal voluntary contraction (MVC) were measured before and after the intervention. The walking distance, the dyspnea, and the heart rate were improved after the training period (p < 0.001) for both groups (p < 0.05). The ET + RT + NMES group showed better improvement than the ET + RT group in terms of 6MWD. CoPML, CoPAP, and CoPV were significantly (p < 0.001; p < 0.05; p < 0.001, respectively) more improved in EO and EC conditions in the ET + RT + NMES group than the ET + RT group. BBS, TUG, and MVC values improved in both groups after the training (p < 0.001). The performances in TUG and MVC tests were significantly greater in the ET + RT + NMES group than those in the ET + RT group (p < 0.01; p < 0.001, respectively). Combining NMES, RT, and ET improves balance in patients with COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) patients have demonstrated prominent balance impairment [1] compared to healthy age-matched controls [2]. e deficit in balance control is identified as one of the risk factors of falls in subjects with COPD and alters their daily-life activities [3, 4]
Forty-two male patients accepted to participate in the study. ey were recruited from the department of physiology and lung function testing of Farhat Hached Hospital in Sousse in the period between 15/01/2016 and 15/09/2016. e criteria of inclusion were COPD diagnosed by pulmonary function testing, clinically stable, without other obstructive diseases, absence of heart diseases, absence of neuromuscular diseases, and fall in the past five years or recent near-fall
Exercise Tolerance. e post hoc test (Table 4) showed that the 6MWD, the SpO2 peak, and the maximal voluntary contraction (MVC) enhanced for both groups (p < 0.001) after the intervention. e 6MWD and the MVC increased significantly (p < 0.001) more for the endurance training (ET) + resistance training (RT) + neuromuscular electrical stimulation (NMES) group than for the ET + RT group after the training program

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) patients have demonstrated prominent balance impairment [1] compared to healthy age-matched controls [2]. e deficit in balance control is identified as one of the risk factors of falls in subjects with COPD and alters their daily-life activities [3, 4]. Chronic obstructive pulmonary disease (COPD) patients have demonstrated prominent balance impairment [1] compared to healthy age-matched controls [2]. Physical inactivity, and limited mobility are well known to weaken balance control [2,3,4]. The reduced quadriceps’ muscle strength is associated to balance impairment in patients with COPD [5]. As a pillar of pulmonary rehabilitation, plays an essential role in improving muscle strength, exercise tolerance, and quality of life [6]. Despite the well-known positive effects of exercise training in patients with COPD, the best modality of exercise is still under discussion, and it depends on the physiologic requirement.

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