title: Peripheral muscle strength training in bed-bound patients with COPD receiving mechanical ventilation: effect of electrical stimulation.
abstract: OBJECTIVE
  To compare the effects of active limb mobilization (ALM) with or without electrical stimulation (ES) on muscle strength, respiratory rate (RR), heart rate, oxygen saturation, and time needed to transfer from bed to chair in two groups of patients with COPD.
  
  
  METHODS
  Randomized, controlled study.
  
  
  METHODS
  Respiratory high-dependency care unit.
  
  
  METHODS
  Twenty-four bed-bound patients with chronic hypercapnic respiratory failure due to COPD who were receiving mechanical ventilation, with marked peripheral muscle hypotonia and atrophy.
  
  
  METHODS
  Patients were randomly assigned either to ALM alone or to ALM plus ES (ALM/ES). ES was applied using square-wave alternate, symmetric, and compensated impulses for 30 min bid. The duration of treatment was 28 days for all patients.
  
  
  RESULTS
  Muscle strength improved significantly in the overall group of patients (from 1.75 +/- 0.73 to 3.44 +/- 0.65, p < 0.05). Comparing the change (end minus beginning) of the analyzed variables, ALM/ES significantly improved muscle strength (2.16 +/- 1.02 vs 1.25 +/- 0.75, p = 0.02) and RR (- 1.91 +/- 1.72 vs 0.41 +/- 1.88, p = 0.004), and decreased the number of days needed to transfer from bed to chair (10.75 +/- 2.41 days vs 14.33 +/- 2.53 days, p = 0.001).
  
  
  CONCLUSIONS
  In bed-bound patients with COPD receiving mechanical ventilation, with marked peripheral muscle hypotonia and atrophy, application of ES in addition to classical ALM significantly improved muscle strength and decreased the number of days needed to transfer from bed to chair.
authors.affiliation: Pulmonary Department, Scientific Institute of Montescano, Fondazione Salvatore Maugeri IRCCS, Montescano, Italy. ezanotti@fsm.it
authors.forename: Ercole
authors.initials: E
authors.lastname: Zanotti
authors.forename: Guido
authors.initials: G
authors.lastname: Felicetti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Maini
authors.forename: Claudio
authors.initials: C
authors.lastname: Fracchia
mesh_terms: D000368:Aged; D001510:Bed Rest; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation* / Q000628:therapy*; D012121:Respiration, Artificial; D013997:Time Factors