title: [Electrostimulation in the rehabilitation of patients with severe COPD: pertinent or not].
abstract: BACKGROUND
  The degree of dyspnoea and muscular dysfunction during an exacerbation of COPD are so severe in some patients that they are unable to follow a traditional exercise training programme based on whole body activity (walking, cycling). Some alternative strategies like electrostimulation may be considered to initiate retraining as soon as possible, to break the vicious circle of exacerbations and improve the prognosis of these patients.
  
  
  METHODS
  Five randomised studies with a control group have analysed the effects of electrostimulation in COPD. They show that this technique does not cause dyspnoea and is well tolerated by the patients regardless of their severity; that that it can improve peripheral muscular function, effort tolerance, dyspnoea and quality of life.
  
  
  CONCLUSIONS
  The preliminary results seem to indicate that electrostimulation probably has a place in respiratory rehabilitation. We think that it should be considered as an alternative to classical retraining in COPD patients with loss of independence during an exacerbation. However, further larger, standardised studies are necessary to confirm the clinical and functional benefits of this technique, to understand the underlying mechanisms and define the precise therapeutic indications.
authors.affiliation: Clinique du Souffle-La-Vallonie, groupe Fontalvie, 800, avenue Joseph-Vallot, 34700 Lodève, France.
authors.forename: A
authors.initials: A
authors.lastname: Couillard
authors.forename: C
authors.initials: C
authors.lastname: Prefaut
mesh_terms: D003131:Combined Modality Therapy; D004417:Dyspnea / Q000523:psychology / Q000534:rehabilitation; D005081:Exercise Therapy; D006801:Humans; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life / Q000523:psychology; D016032:Randomized Controlled Trials as Topic; D004561:Transcutaneous Electric Nerve Stimulation