title: Home-based neuromuscular electrical stimulation improves exercise tolerance and health-related quality of life in patients with COPD.
abstract: BACKGROUND
  This retrospective, observational study of a routine clinical practice reports the feasibility and efficiency of home-based pulmonary rehabilitation (PR), including transcutaneous neuromuscular electrical stimulation (NMES) or usual endurance physical exercise (UEPE), on exercise tolerance, anxiety/depression, and health-related quality of life (HRQoL) in patients with COPD.
  
  
  METHODS
  Seventy-one patients with COPD participated in home-based PR with NMES (Group NMES [GNMES]), while 117 patients participated in home-based PR with the UEPEs (Group UEPE [GUEPE]). NMES was applied for 30 minutes twice a day, every day. The endurance exercises in GUEPE began with a minimum 10-minute session at least 5 days a week, with the goal being 30-45 minutes per session. Three upper and lower limb muscle strengthening exercises lasting 10-15 minutes were also proposed to both the groups for daily practice. Moreover, PR in both the groups included a weekly 90-minute session based on an educational needs assessment. The sessions comprised endurance physical exercise for GUEPE, NMES for GNMES, resumption of physical daily living activities, therapeutic patient education, and psychosocial support to facilitate health behavior changes. Before and after PR, functional mobility and physical exercise capacity, anxiety, depression, and HRQoL were evaluated at home.
  
  
  RESULTS
  The study revealed that NMES significantly improved functional mobility (-18.8% in GNMES and -20.6% in GUEPE), exercise capacity (+20.8% in GNMES and +21.8% in GUEPE), depression (-15.8% in GNMES and -30.1% in GUEPE), and overall HRQoL (-7.0% in GNMES and -18.5% in GUEPE) in the patients with COPD, regardless of the group (GNMES or GUEPE) or severity of airflow obstruction. Moreover, no significant difference was observed between the groups with respect to these data (P>0.05).
  
  
  CONCLUSIONS
  Home-based PR including self-monitored NMES seems feasible and effective for severely disabled COPD patients with severe exercise intolerance.
authors.affiliation: Faculté des Sciences du Sport, Université de Rouen, CETAPS, EA 3832, Mont Saint Aignan, Beuvry, France.
authors.forename: Jérémy B
authors.initials: JB
authors.lastname: Coquart
authors.affiliation: Service de Pneumologie, Centre Hospitalier de Béthune, Beuvry, France; Formaction Santé, Perenchies, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Grosbois
authors.affiliation: Service de Pneumologie et Immunoallergologie, Centre Hospitalier Universitaire de Lille, Hôpital Calmette, Université de Lille 2, France.
authors.forename: Cecile
authors.initials: C
authors.lastname: Olivier
authors.affiliation: Service de Pneumologie, Centre Hospitalier de Béthune, Beuvry, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Bart
authors.affiliation: Faculté des Sciences du Sport, Université de Rouen, CETAPS, EA 3832, Mont Saint Aignan, Beuvry, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Castres
authors.affiliation: Service de Pneumologie et Immunoallergologie, Centre Hospitalier Universitaire de Lille, Hôpital Calmette, Université de Lille 2, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Wallaert
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003131:Combined Modality Therapy; D003863:Depression / Q000517:prevention & control / Q000523:psychology; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000294:innervation*; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: NMES; chronic obstructive pulmonary disease; global management program; pulmonary rehabilitation; severity of airflow obstruction