Tristan Bonnevie1, Francis-Edouard Gravier2, David Debeaumont3, Catherine Viacroze4, Jean-François Muir5, Antoine Cuvelier6, Marie Netchitaïlo7, Anne-Laure Roy7, Jean Quieffin8, Marie-Hélène Marques8, Clément Médrinal9, Johan Dupuis2, Catherine Tardif10. 1. ADIR Association, Rouen University Hospital, Rouen, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France. Electronic address: rehabilition@adir-hautenormandie.com. 2. ADIR Association, Rouen University Hospital, Rouen, France. 3. ADIR Association, Rouen University Hospital, Rouen, France; Physiology Department, Rouen University Hospital, Rouen, France. 4. Thoracic Oncology and Respiratory Intensive Department, Rouen University Hospital, Rouen, France. 5. ADIR Association, Rouen University Hospital, Rouen, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France. 6. Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France; Thoracic Oncology and Respiratory Intensive Department, Rouen University Hospital, Rouen, France. 7. Physiology Department, Rouen University Hospital, Rouen, France. 8. Medico-surgical Intensive Care Unit, Jacque Monod Hospital, Le Havre, France. 9. Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France; Medico-surgical Intensive Care Unit, Jacque Monod Hospital, Le Havre, France. 10. ADIR Association, Rouen University Hospital, Rouen, France; Normandie University, UNIROUEN, EA UPRES 3830, Rouen University Hospital, Haute Normandie Research and Biomedical Innovation, Rouen, France; Physiology Department, Rouen University Hospital, Rouen, France.
Abstract
OBJECTIVE: To assess the additional effect of a home-based neuromuscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD). DESIGN: Single-blind, multicenter randomized trial. SETTING: Three PR centers. PARTICIPANTS: Subjects with severe to very severe COPD (N=73; median forced expiratory volume in 1 second, 1L (25th-75th percentile, 0.8-1.4L) referred for PR. Twenty-two subjects discontinued the study, but only 1 dropout was related to the intervention (leg discomfort). INTERVENTION: Subjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, 5 time per week) or PR without NMES for 8 weeks. MAIN OUTCOME MEASURE: The 6-minute walk test (6MWT) was used to assess functional capacity. RESULTS: Eighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (P<.01), peak oxygen consumption (P=.02), maximal workload (P<.01), modified Medical Research Council dyspnea scale (P<.01), and Saint George's Respiratory Questionnaire total score (P=.01). There was no significant difference in the magnitude of change for any outcome between groups. CONCLUSIONS: Home-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD; moreover, it may have been a burden for some patients.
RCT Entities:
OBJECTIVE: To assess the additional effect of a home-based neuromuscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD). DESIGN: Single-blind, multicenter randomized trial. SETTING: Three PR centers. PARTICIPANTS: Subjects with severe to very severe COPD (N=73; median forced expiratory volume in 1 second, 1L (25th-75th percentile, 0.8-1.4L) referred for PR. Twenty-two subjects discontinued the study, but only 1 dropout was related to the intervention (leg discomfort). INTERVENTION: Subjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, 5 time per week) or PR without NMES for 8 weeks. MAIN OUTCOME MEASURE: The 6-minute walk test (6MWT) was used to assess functional capacity. RESULTS: Eighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (P<.01), peak oxygen consumption (P=.02), maximal workload (P<.01), modified Medical Research Council dyspnea scale (P<.01), and Saint George's Respiratory Questionnaire total score (P=.01). There was no significant difference in the magnitude of change for any outcome between groups. CONCLUSIONS: Home-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD; moreover, it may have been a burden for some patients.