title: Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients.
abstract: BACKGROUND
  Neuromuscular electrical stimulation (NMES) improves muscle performance and exercise tolerance in chronic obstructive pulmonary disease (COPD) patients. In contrast, no study has assessed the effect of NMES on dynamic hyperinflation (DH) in COPD. This study investigated the effect of short-term, high-frequency NMES on DH in patients with COPD.
  
  
  METHODS
  Twenty patients were randomly allocated to either a NMES applied bilaterally to the quadriceps muscles (n = 11: 8 weeks, 5 days/week, twice/day, 45 min/session) or a control group (n = 09). All patients received respiratory physical therapy and stretching exercises. Free fat mass, pulmonary function, time to exercise tolerance (Tlim), 6-min walk test distance (6-MWTD), tumor necrosis factor (TNF-α) and β-endorphin levels, Borg dyspnea and leg score (BDS and BLS) and quality of life by the St. George's Respiratory Questionnaire score (SGRQ) were examined before and after the intervention.
  
  
  RESULTS
  Compared with the control group, NMES increased FEV1 and FEV1/FVC, 6-MWD and Tlim (P < 0.01) and reduced BDS and SGRQ (P < 0.01). Additionally, changes in the Tlim were positively correlated with respiratory improvements in FEV1 (rho = 0.48, P < 0.01). Also, NMES reduced TNF-α and increased β-endorphin levels, compared with the control group (P < 0.001).
  
  
  CONCLUSIONS
  In summary, 8 weeks of NMES promotes reduction of the perceived sensation of dyspnea during exercise in patients with COPD. This finding is accompanied by improvements in FEV1, exercise tolerance and quality of life, and DH. Interestingly, these findings may be associated with enhanced vasodilatory function and a reduction in inflammatory responses.
  
  
  BACKGROUND
  NCT01695421.
authors.affiliation: Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Paulo J C
authors.initials: PJ
authors.lastname: Vieira
authors.affiliation: Physical Therapy Division and Intensive Care Unit from Hospital de Clínicas de Porto Alegre, Brazil.
authors.forename: Adriana M Güntzel
authors.initials: AM
authors.lastname: Chiappa
authors.affiliation: Physical Therapy Division, University of Brasilia, Brasília, Brazil.
authors.forename: Gerson
authors.initials: G
authors.lastname: Cipriano
authors.affiliation: Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Daniel
authors.initials: D
authors.lastname: Umpierre
authors.affiliation: Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Arena
authors.affiliation: Exercise Pathophysiology Research Laboratory and Cardiology Division, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil; Serra Gaucha College, Physical Therapy Division, Brazil. Electronic address: gchiappa@hcpa.ufrgs.br.
authors.forename: Gaspar R
authors.initials: GR
authors.lastname: Chiappa
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000379:methods; D001823:Body Composition / Q000502:physiology; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance / Q000502:physiology; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D052097:Quadriceps Muscle / Q000503:physiopathology; D011788:Quality of Life; D015656:Respiratory Mechanics / Q000502:physiology; D012132:Respiratory Muscles / Q000503:physiopathology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D001615:beta-Endorphin / Q000378:metabolism
chemical_list: D014409:Tumor Necrosis Factor-alpha; D001615:beta-Endorphin
keywords: Body composition; Dynamic hyperinflation; Dyspnea; Electrical stimulation; Exertion; Pulmonary rehabilitation