The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effect of Neuromuscular Electrical Stimulation on Pulmonary Function, Gait Ability, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

  • Received : 2018.07.25
  • Accepted : 2018.08.30
  • Published : 2018.08.31
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Abstract

Purpose: This study aims to investigate the changes in pulmonary function, gait ability, and quality of life when NMES is applied along with CBE and to provide basic clinical data to be used in pulmonary rehabilitation guidelines for patients with COPD to treat patients with severe COPD. Methods: For this study, CBE and NMES of quadriceps femoris on both sides were applied to the experimental group (n=10), and only CBE was applied to the control group (n=10). For a pre-test, a 6-minute walk test was performed, and pulmonary function and health-related quality of life were measured. Moreover, an exercise program was applied to each group for 30 minutes per session, 5 times a week, for 6 weeks. After that, a post-test was conducted the same way as the pre-test. Results: In the within-group comparison, there were significant differences in forced expiratory volume in one second, 6-minute walk test and health-related quality of life between the experimental group and the control group (p<0.01)(p<0.05). In the between-group comparison, the experimental group showed an increase in forced expiratory volume in one second and 6-minute walk test (p<0.05) and showed a decline in health-related quality of life (p<0.05). Conclusion: The 6-weeks NMES program improved health-related quality in patients with severe COPD by increasing expiratory volume by reinforcing the function of quadriceps femoris. This finding implies that NMES could be an alternative mode for improving physical functions of patients with severe COPD, who cannot participate in a breathing exercise program or are reluctant to participate.

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References

  1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. GOLD. 2015.
  2. Jeon CM, Oh KO. Prevalence of chronic obstructive pulmonary disease among adults over 40 years old in Korea, 2009-2013. Public Health Weekly Report, KCDC. 2015;8(15):334-6.
  3. Man WD, Soliman MG, Gearing J et al. Symptoms and quadriceps fatigability after walking and cycling in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003;168(5):562-7. https://doi.org/10.1164/rccm.200302-162OC
  4. Kang JI, Jeong DK, Choi H. The effect of fatigue of patients with chronic obstructive pulmonary disease on depression and the health-related quality of life. J Kor Phys Ther. 2014;26(4):262-8.
  5. Choi JC, Han DU. The effects of quadriceps setting exercise and electrical stimulation on improvement of quadriceps muscle strength. J Kor Phys Ther. 2001;13(2):273-80.
  6. Polkey MI, Spruit MA, Edwards LD et al. Six-minute-walk test in chronic obstructive pulmonary disease: minimal clinically important difference for death or hospitalization. Am J Respir Crit Care Med. 2013;187(4):382-6. https://doi.org/10.1164/rccm.201209-1596OC
  7. Seymour JM, Spruit MA, Hopkinson NS et al. The prevalence of quadriceps weakness in COPD and the relationship with disease severity. Eur Respir J. 2010;36(1):81-8. https://doi.org/10.1183/09031936.00104909
  8. Gagnon P, Saey D, Vivodtzev I et al. Impact of pre induced quadriceps fatigue on exercise response in chronic obstructive pulmonary disease and healthy subjects. J Appl Physiol. 2009;107(3):832-40. https://doi.org/10.1152/japplphysiol.91546.2008
  9. Kim GW, Kim JS. Analysis of surface EMG power spectrum and muscle fatigue depending on the variable of neuromuscular electrical stimulation. J Kor Phys Ther. 2014;26(5):280-9.
  10. Sbruzzi G, Schaan BD, Pimentel GL et al. Effects of low frequency functional electrical stimulation with 15 and 50 Hz on muscle strength in heart failure patients. Disabil Rehabil. 2011;33(6):486-93. https://doi.org/10.3109/09638288.2010.498551
  11. Jeong BO, Kwon YS, Kim JS. The effect of neuromuscular electrical stimulation on the spasticity of elbow flexor in stroke patients. J Kor Phys Ther. 1999;11(3):89-96.
  12. Reeves ND, Narici MV, Maganaris CN. In vivo human muscle structure and function: adaptations to resistance training in old age. Exp physiol. 2004;89(6):675-89. https://doi.org/10.1113/expphysiol.2004.027797
  13. Park SJ, Lee JH, Lee DJ. The effects of electrical stimulation method on muscle strength, pain, range of motion, fear avoidance-belief in patients with anterior cruciate ligament reconstruction. J KAIS. 2017;18(6):538-46.
  14. Taradaj J, Halski T, Kucharzewski M et al. The effect of neuromuscular electrical stimulation on quadriceps strength and knee function in professional soccer players: return to sport after ACL reconstruction. Biomed Res Int. 2013;2013:802534.
  15. Coghlan S, Crowe L, McCarthy Persson U et al. Electrical muscle stimulation for deep stabilizing muscles in abdominal wall. Conf Proc IEEE Eng Med Biol Soc. 2008;2756-9.
  16. Park D, Ryu JS. Neuromuscular electrical stimulation for swallowing. J Kor Dysphagia Soc. 2016;6(1):1-6.
  17. SillenMJ, Franssen FM, Vaes AW et al. Metabolic load during strength training or NMES in individuals with COPD: Results from the DICES trial. BMC Pulm Med. 2014;14:146. https://doi.org/10.1186/1471-2466-14-146
  18. Pohl PS, Duncan PW, Perera S et al. Influence of stroke-related impairments on performance in 6-minute walk test. J Rehabil Res Dev. 2002;39(4):439-44.
  19. Neder JA, Sword D, Ward SA et al. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax. 2002;57(4):333-7. https://doi.org/10.1136/thorax.57.4.333
  20. Black PN, Ching PS, Beaumont B et al. Changes in elastic fibres in the small airways and alveoli in COPD. Eur Respir J. 2008;31(5):998-1004. https://doi.org/10.1183/09031936.00017207
  21. Spruit MA, Singh SJ, Garvey C et al. An official American thoracic society/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188(8):e13-64. https://doi.org/10.1164/rccm.201309-1634ST
  22. Kim BR, Kang JI, Kim YN et al. Effects of respiratory muscle strengthening exercise on respiratory function and activities of daily living in stroke patients. J Kor Phys Ther. 2017;29(1):1-6. https://doi.org/10.18857/jkpt.2017.29.1.1
  23. Wu X, Hou L, Bai W. Effects of breathing training on quality of life and activities of daily living in elderly patients with stable severe chronic obstructive pulmonary disease. Chin J Rehabili Med. 2006;21(4):307-10.
  24. Paulin E, Yamaguti WP, Chammas MC et al. Influence of diaphragmatic mobility on exercise tolerance and dyspnea in patients with COPD. Respir Med. 2007;101(10):2113-8. https://doi.org/10.1016/j.rmed.2007.05.024
  25. Lee HY. The effects of diaphragm breathing exercise and feedback breathing exercise on pulmonary function and diaphragm thickness in normal subjects. Daegu University. Dissertation of Doctorate Degree. 2015.
  26. Yamaguti WP, Claudino RC, Neto AP et al. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: A randomized controlled trial. Arch Phys Med Rehabili. 2012;93(4):571-7. https://doi.org/10.1016/j.apmr.2011.11.026
  27. Shim YJ. Improvement of respiratory function by breathing exercise in patients with cervical spinal cord injuries. International University of Korea. Dissertation of Master's Degree. 2012.
  28. Lim SW. The effects of a thoracic mobilization exercise using the Kaltenborn-evjenth orthopedic manual therapy on the pulmonary function and respiratory muscle activity of adults in their 20's. Yongin University. Dissertation of Doctorate Degree. 2017.
  29. Jeong DK. The effects of breathing exercise on respiratory synergist muscle activity and SpO2 in patients with chronic obstructive pulmonary disease. J Kor Phys Ther. 2015;27(4):234-9. https://doi.org/10.18857/jkpt.2015.27.4.234
  30. Kang JI, Jeong DK, Choi H. The effect of types of respiratory exercise on respiratory muscle activity and health-related quality of life of patients with severe chronic obstructive pulmonary disease. J Kor Phys Ther. 2016;28(1):46-51.
  31. Takita K, Herlenius EA, Lindahl SG et al. Actions of opioids on respiratory activity via activation of brainstem mu-, delta- and kappa-receptors; an in vitro study. Brain Res. 1997;778(1):233-41. https://doi.org/10.1016/S0006-8993(97)01105-0
  32. Quittan M, Wiesinger GF, Sturm B et al. Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure: A single-blind, randomized, controlled trial. Am J Phys Med Rehabil. 2001;80(3):206-14. https://doi.org/10.1097/00002060-200103000-00011
  33. Karavidas AI, Raisakis KG, Parissis JT et al. Functional electrical stimulation improves endothelial function and reduces peripheral immune responses in patients with chronic heart failure. Eur J Cardiovasc Prev Rehabil. 2006;13(4):592-7. https://doi.org/10.1097/01.hjr.0000219111.02544.ff
  34. Bustamante V, Lopez de Santa Maria E, Gorostiza A et al. Muscle training with repetitive magnetic stimulation of the quadriceps in severe COPD patients. Respir Med. 2010;104(2):237-45. https://doi.org/10.1016/j.rmed.2009.10.001
  35. Vieira PJ, Chiappa AM, Cipriano G Jr et al. Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respir Med. 2014;108(4):609-20. https://doi.org/10.1016/j.rmed.2013.12.013
  36. Steiner MC, Singh SJ, Morgan MD. The contribution of peripheral muscle function to shuttle walking performance in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2005;25(1):43-9. https://doi.org/10.1097/00008483-200501000-00010
  37. Vivodtzev I, Debigare R, Gagnon P et al. Functional and muscular effects of neuromuscular electrical stimulation in patients with severe COPD: A randomized clinical trial. Chest. 2012;141(3):716-25. https://doi.org/10.1378/chest.11-0839

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