Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass

Author Napolis, Lara Maris Autor UNIFESP Google Scholar
Dal Corso, Simone Autor UNIFESP Google Scholar
Neder, Jose Alberto Autor UNIFESP Google Scholar
Malaguti, Carla Autor UNIFESP Google Scholar
Gimenes, Ana Cristina Oliveira Autor UNIFESP Google Scholar
Nery, Luiz Eduardo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
University Nove de Julho Division of Rehabilitation
Abstract BACKGROUND: High-frequency neuromuscular electrical stimulation increases exercise tolerance in patients with advanced chronic obstructive pulmonary disease (COPD patients). However, it is conceivable that its benefits are more prominent in patients with better-preserved peripheral muscle function and structure. OBJECTIVE: To investigate the effects of high-frequency neuromuscular electrical stimulation in COPD patients with better-preserved peripheral muscle function. Design: Prospective and cross-over study. METHODS: Thirty COPD patients were randomly assigned to either home-based, high-frequency neuromuscular electrical stimulation or sham stimulation for six weeks. The training intensity was adjusted according to each subject's tolerance. Fat-free mass, isometric strength, six-minute walking distance and time to exercise intolerance (Tlim) were assessed. RESULTS: Thirteen (46.4%) patients responded to high-frequency neuromuscular electrical stimulation; that is, they had a post/pre Δ Tlim >10% after stimulation (unimproved after sham stimulation). Responders had a higher baseline fat-free mass and six-minute walking distance than their seventeen (53.6%) non-responding counterparts. Responders trained at higher stimulation intensities; their mean amplitude of stimulation during training was significantly related to their fat-free mass (r = 0.65; p<0.01). Logistic regression revealed that fat-free mass was the single independent predictor of Tlim improvement (odds ratio [95% CI] = 1.15 [1.04-1.26]; p<0.05). CONCLUSIONS: We conclude that high-frequency neuromuscular electrical stimulation improved the exercise capacity of COPD patients with better-preserved fat-free mass because they tolerated higher training stimulus levels. These data suggest that early training with high-frequency neuromuscular electrical stimulation before tissue wasting begins might enhance exercise tolerance in patients with less advanced COPD.
Keywords Chronic obstructive pulmonary disease
electrical stimulation
body composition
pulmonary rehabilitation
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Grant number FAPESP: 01/09866-3
FAPESP: 10060-3
Date 2011-01-01
Published in Clinics. Faculdade de Medicina / USP, v. 66, n. 3, p. 401-406, 2011.
ISSN 1807-5932 (Sherpa/Romeo, impact factor)
Publisher Faculdade de Medicina / USP
Extent 401-406
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000290351300006
SciELO ID S1807-59322011000300006 (statistics in SciELO)

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