title: Efficacy of neuromuscular electrical stimulation in patients with COPD followed in intensive care unit.
abstract: BACKGROUND
  Serious problems on muscle strength and functional status can be seen in bedridden-patients with chronic obstructive pulmonary diseases (COPD) receiving mechanical ventilation. We aimed to investigate the impact of active extremity mobilization and neuromuscular electrical stimulation (NMES) on weaning processes, discharge from hospital and inflammatory mediators in COPD patients receiving mechanical ventilation.
  
  
  METHODS
  Thirty conscious COPD patients (F/M:15/15) hospitalized in the intensive care unit (ICU) with diagnosis of respiratory failure were enrolled to this study. Patients were randomized into three groups, including 10 patients for each. Active extremity-exercise training and NMES were applied to Group-1, only NMES was applied to Group-2 and active extremity exercise training was applied to Group-3. Muscle strengths, mobilization duration and weaning situation were evaluated. Serum cytokine levels were evaluated.
  
  
  RESULTS
  Lower extremity muscle-strength was significantly improved in Group-1 (from 3.00 to 5.00, P = 0.014) and 2 (from 4.00 to 5.00, P = 0.046). Upper extremity muscle strength was also significantly improved in all three groups (from 4.00 to 5.00 for all groups, P = 0.038, P = 0.046 and P = 0.034, respectively). Duration of mobilization and discharge from the ICU were similar among groups. There was a significant decrease in serum interleukin (IL)-6 level in Group-1 and in serum IL-8 level in Group-1 and Group-2 after rehabilitation.
  
  
  CONCLUSIONS
  This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.
authors.affiliation: Department of Chest Diseases, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Olcay
authors.initials: O
authors.lastname: Akar
authors.affiliation: Department of Chest Diseases, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Ersin
authors.initials: E
authors.lastname: Günay
authors.affiliation: Department of Chest Diseases, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Sevinc
authors.initials: S
authors.lastname: Sarinc Ulasli
authors.affiliation: Department of Physical Treatment and Rehabilitation, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Alper Murat
authors.initials: AM
authors.lastname: Ulasli
authors.affiliation: Department of Radiology, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kacar
authors.affiliation: Department of Chest Diseases, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Sariaydin
authors.affiliation: Department of Physical Treatment and Rehabilitation, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Solak
authors.affiliation: Department of Medical Biochemistry, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Sefa
authors.initials: S
authors.lastname: Celik
authors.affiliation: Department of Chest Diseases, Afyon Kocatepe University, Faculty of Medicine, Afyonkarahisar, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ünlü
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016207:Cytokines / Q000097:blood; D004599:Electric Stimulation Therapy / Q000379:methods*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D018908:Muscle Weakness / Q000517:prevention & control* / Q000534:rehabilitation; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D012121:Respiration, Artificial / Q000009:adverse effects; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000628:therapy; D015300:Ventilator Weaning / Q000592:standards
chemical_list: D015415:Biomarkers; D016207:Cytokines; D015850:Interleukin-6; D016209:Interleukin-8
keywords: chronic obstructive pulmonary disease - inflammation - intensive care - neuromuscular electrical stimulation - pulmonary rehabilitation - weaning