Source: Annual Congress 2008 - Physiological response to exercise performance
Disease area: Airway diseases

Abstract

Background
Conventional exercise training often leads to overt sensations of dyspnoea in severely disabled patients with COPD. NMES is a new training modality in which lower-limb muscles can be trained with an acceptable (relatively low) metabolic response accompanied by a low perception of dyspnoea. The purpose is to review systematically the effects of NMES on skeletal muscle strength, exercise capacity and health-related quality of life (HRQoL) in COPD.
Methods
Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) were searched in the databases of Medline, Embase, Cochrane Controlled Clinical Trials Register, CINAHL, The Physical Therapy Evidence Database (PEDro) and in reference lists. The PEDro scale was used to rate the methodological quality (scores can range from 0 (=worst) to 10 points (=optimum)).
Results
Eighty-five potentially relevant trials were identified. Eighty studies were excluded (no RCT/CCT and/or no NMES of lower-limb muscles and/or no COPD). Five high-quality trials (trials with > 4 points at the PEDro scale) were identified (sample size range: 15 to 24 COPD patients). All of them were RCTs. PEDro scores ranged from 6 to 7 points. Four studies showed that NMES improved skeletal muscle strength, three studies showed an improvement in exercise capacity and two studies showed an improvement in HRQoL.
Conclusions
On average, NMES is a training modality with positive effects on skeletal muscle strength, exercise capacity and HRQoL in COPD patients. Nevertheless, additional RCTs with larger sample sizes appear to be warranted.

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M. J. H. Sillen, R. M. Eterman, P. P. Janssen, C. M. Speksnijder, E. F. M. Wouters, M. A. Spruit (Horn, Utrecht, Maastricht, Netherlands). Effects of neuromuscular electrical stimulation (NMES) of lower-limb muscles in patients with chronic obstructive pulmonary disease (COPD): a systematic review of randomized controlled trials. Eur Respir J 2008; 32: Suppl. 52, 3298

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