Evaluation of the Effects of Neuromuscular Electrical Stimulation of The Lower Limbs Combined with Pulmonary Rehabilitation on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a systemic disease with multiple extrapulmonary manifestations including impeded skeletal muscle function, leading to decreased muscular strength and endurance in patients with COPD. Pulmonary rehabilitation eases the symptoms of the condition and produces increased muscular endurance. Neuromuscular electrical stimulation (NMES) may serve as a treatment alternative to traditional pulmonary rehabilitation. The aim of the study was to assess the effects of NMES combined with pulmonary rehabilitation on exercise tolerance in patients in comparison with pulmonary rehabilitation alone. The subjects included 30 patients with COPD randomly assigned to one of the two groups. The first group consisted of 15 patients who were treated with neuromuscular electrical stimulation at frequency of 35Hz and pulmonary rehabilitation (NMES+RP). The second group comprised 15 patients treated with pulmonary rehabilitation only (RP). Pre- and poststudy assessments were performed. The retrospective evaluation including an exercise tolerance test (i.e. six minute walk test (6MWT)), spirometry and blood gasometry was carried out after 3 weeks. Twenty-eight patients in total completed the study. In the NMES+RP group, an increase in exercise tolerance manifested by a longer distance walked in the 6MWT was observed in comparison to the pulmonary rehabilitation group. No effects of NMES combined with pulmonary rehabilitation on selected spirometric and gasometric parameters in patients with COPD were observed in comparison with traditional pulmonary rehabilitation. The acquired results suggest that NMES of the lower limbs may be applied as an additional form of pulmonary rehabilitation in patients with COPD.