title: Comparison of the effects of neuromuscular electrical stimulation and endurance training in patients with severe chronic obstructive pulmonary disease.
abstract: BACKGROUND
  In severely disabled patients who are not capable of following formal pulmonary rehabilitation (PR) and/or tolerating higher training intensities, neuromuscular electrical stimulation (NMES) has been successfully utilized as a localized training method.
  
  
  METHODS
  In this non-randomized controlled observational study 50 patients with severe chronic obstructive pulmonary disease (COPD), who were allocated into two groups. Endurance training group (ET) (n= 27) and NMES group (n= 23). To compare the effects of NMES and ET on health-related quality of life (HRQOL), exercise capacity, muscle strength, dyspnea, psychological status, and body composition in patients with severe COPD. Before and after PR program, the study parameters were assessed using the Medical Research Council (MRC) scale, incremental and endurance shuttle walking tests (ISWT, ESWT), manual muscle testing (MMT), the St. George's Respiratory Questionnaire (SGRQ), bioelectrical impedance analysis, and the Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  After the PR program, walking distance and endurance time significantly increased in both groups (p< 0.001 for each), whereas the MRC scores of both groups significantly decreased (p< 0.001 for each). In the ET group, significant decreases were noted in all domains of SGRQ and HADS. In the NMES group, significant improvements were observed in the HADS scores and in all SGRQ domain except symptom domain. No significant differences were observed between the NMES and ET groups regarding the changes from baseline to after PR program in walking distance (p= 0.140), endurance time (p= 0.376), the MRC (p= 0.540), HRQOL (p> 0.05) and HADS (p> 0.05) scores, body-mass index (BMI) (p= 0.49), fat-free mass (FFM) (p= 0.50) and fat-free mass index (FFMI) (p= 0.94).
  
  
  CONCLUSIONS
  NMES can be used as an effective treatment strategy in PR programs for peripheral muscle training in patients with severe COPD.
authors: Department of Pulmonary Rehabilitation and Home Care Center, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey. dicleyilmaz@hotmail.com.
authors: Dicle
authors: D
authors: Kaymaz
authors: Pınar
authors: P
authors: Ergün
authors: Ebru
authors: E
authors: Demirci
authors: Neşe
authors: N
authors: Demir
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D004417:Dyspnea; D004599:Electric Stimulation Therapy; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D009752:Nutritional Status; D010807:Physical Endurance; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D011788:Quality of Life; D012907:Smoking; D011795:Surveys and Questionnaires; D016896:Treatment Outcome