Interest of neuromuscular electro-stimulation (NMES) in COPD patients during an ambulatory comprehensive respiratory rehabilitation program

Introduction: COPD often leads to peripheral muscle atrophy and weakness. NMES is commonly used to improve muscle function and structure and is currently considered as an adjunct to exercise training in COPD patients with severe muscular deconditioning. The optimal parameters of stimulation and its indication in COPD patients are not yet well known. Aim of the study: To determine the interest of NMES in COPD patients during an ambulatory comprehensive respiratory rehabilitation program (RRP). Material and methods: We included prospectively 16 COPD patients GOLD 3-4 who take part to a RRP during 12 weeks. The subjects were all unable to walk more than 350 meter at the 6-minute walking distance (6MWD) and were randomized in two groups: – 8 patients performing the RRP (group R) – 8 patients performing the RRP plus NMES (group R-ES) We assessed the spirometry, the 6MWD, the VO2 max, the maximal work load developed on the cyclo-ergometer, the quality of life as well as the evaluation of the strength and the endurance of the quadriceps at T0 and T12 weeks. NMES was performed bilaterally on the quadriceps of the vastus medialis and vastus lateralis. Results: We observed that the addition of NMES sessions as complementary technique to respiratory rehabilitation significantly increased the quadriceps strength (+21, 6%), as well as the quality of life (+30%), associated with a significant increase of the 6MWD (+25%) in the group R-ES compared with the group R. Conclusion: Further studies are needed to identify the physiologic mechanisms involved in the improvements after NMES as well as its place as adjunct therapy in respiratory rehabilitation.