Clément Medrinal1, Guillaume Prieur2, Yann Combret3, Aurora Robledo Quesada4, David Debeaumont5, Tristan Bonnevie6, Francis Edouard Gravier7, Elise Dupuis Lozeron8, Jean Quieffin2, Olivier Contal9, Bouchra Lamia10. 1. Normandy University, UNIROUEN, and the Institute for Research and Innovation in Biomedicine, Rouen, France; Pulmonology Department, Le Havre Hospital, Montivilliers, France. Electronic address: medrinal.clement.mk@gmail.com. 2. Pulmonology Department, Le Havre Hospital, Montivilliers, France. 3. Institute for Experimental Research, Pulmonology, ORL & Dermatology, Catholic University of Louvain, Brussels, Belgium; Physiotherapy Department, Le Havre Hospital, Montivilliers, France. 4. Intensive Care Unit Department, Le Havre Hospital, Montivilliers, France. 5. Exercise and Respiratory Physiology Department, Bois Guillaume Hospital, Rouen University Hospital, Rouen Cedex, France. 6. Normandy University, UNIROUEN, and the Institute for Research and Innovation in Biomedicine, Rouen, France; ADIR Association, Bois Guillaume, France. 7. ADIR Association, Bois Guillaume, France. 8. Division of Clinical Epidemiology, Geneva University Hospitals, Geneva, Switzerland. 9. University of Applied Sciences and Arts of Western Switzerland (HES-SO), Lausanne, Switzerland. 10. Normandy University, UNIROUEN, and the Institute for Research and Innovation in Biomedicine, Rouen, France; Pulmonology Department, Le Havre Hospital, Montivilliers, France; Intensive Care Unit, Respiratory Department, Rouen University Hospital, Rouen, France.
Abstract
OBJECTIVE: To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake (V˙o2) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD). DESIGN: A randomized, single-blind, placebo-controlled crossover trial. SETTING: Pulmonary rehabilitation department. PARTICIPANTS: Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1.4±0.4L [50.3% predicted]) who had recently begun a respiratory rehabilitation program. INTERVENTION: Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-cycling. MAIN OUTCOME MEASURES: The primary outcome was mean V˙o2 during the 30-minute exercise session. The secondary outcomes were respiratory gas exchange and hemodynamic parameters averaged over the 30-minute endurance session. Lactate values, dyspnea, and perceived muscle fatigue were evaluated at the end of the sessions. RESULTS: FES-cycling increased the physiological response more than the placebo, with a greater V˙o2 achieved of 36.6mL/min (95% confidence interval [CI], 8.9-64.3mL/min) (P=.01). There was also a greater increase in lactate after FES-cycling (+1.5mmol/L [95% CI, .05-2.9mmol/L]; P=.01). FES-cycling did not change dyspnea or muscle fatigue compared with the placebo condition. CONCLUSIONS: FES-cycling effectively increased exercise intensity in patients with COPD. Further studies should evaluate longer-term FES-cycling rehabilitation programs.
RCT Entities:
OBJECTIVE: To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake (V˙o2) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD). DESIGN: A randomized, single-blind, placebo-controlled crossover trial. SETTING: Pulmonary rehabilitation department. PARTICIPANTS: Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1.4±0.4L [50.3% predicted]) who had recently begun a respiratory rehabilitation program. INTERVENTION: Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-cycling. MAIN OUTCOME MEASURES: The primary outcome was mean V˙o2 during the 30-minute exercise session. The secondary outcomes were respiratory gas exchange and hemodynamic parameters averaged over the 30-minute endurance session. Lactate values, dyspnea, and perceived muscle fatigue were evaluated at the end of the sessions. RESULTS:FES-cycling increased the physiological response more than the placebo, with a greater V˙o2 achieved of 36.6mL/min (95% confidence interval [CI], 8.9-64.3mL/min) (P=.01). There was also a greater increase in lactate after FES-cycling (+1.5mmol/L [95% CI, .05-2.9mmol/L]; P=.01). FES-cycling did not change dyspnea or muscle fatigue compared with the placebo condition. CONCLUSIONS:FES-cycling effectively increased exercise intensity in patients with COPD. Further studies should evaluate longer-term FES-cycling rehabilitation programs.