Neder J A, Sword D, Ward S A, Mackay E, Cochrane L M, Clark C J
Department of Respiratory Medicine, Hairmyres Hospital, East Kilbride and Centre for Exercise Science and Medicine, Institute of Biomedical and Life Sciences (IBLS), University of Glasgow, Glasgow, UK.
Thorax. 2002 Apr;57(4):333-7. doi: 10.1136/thorax.57.4.333.
Passive training of specific locomotor muscle groups by means of neuromuscular electrical stimulation (NMES) might be better tolerated than whole body exercise in patients with severe chronic obstructive pulmonary disease (COPD). It was hypothesised that this novel strategy would be particularly effective in improving functional impairment and the consequent disability which characterises patients with end stage COPD.
Fifteen patients with advanced COPD (nine men) were randomly assigned to either a home based 6 week quadriceps femoris NMES training programme (group 1, n=9, FEV(1)=38.0 (9.6)% of predicted) or a 6 week control period before receiving NMES (group 2, n=6, FEV(1)=39.5 (13.3)% of predicted). Knee extensor strength and endurance, whole body exercise capacity, and health related quality of life (Chronic Respiratory Disease Questionnaire, CRDQ) were assessed.
All patients were able to complete the NMES training programme successfully, even in the presence of exacerbations (n=4). Training was associated with significant improvements in muscle function, maximal and endurance exercise tolerance, and the dyspnoea domain of the CRDQ (p<0.05). Improvements in muscle performance and exercise capacity after NMES correlated well with a reduction in perception of leg effort corrected for exercise intensity (p<0.01).
For severely disabled COPD patients with incapacitating dyspnoea, short term electrical stimulation of selected lower limb muscles involved in ambulation can improve muscle strength and endurance, whole body exercise tolerance, and breathlessness during activities of daily living.
对于重度慢性阻塞性肺疾病（COPD）患者，通过神经肌肉电刺激（NMES）对特定运动肌群进行被动训练可能比全身运动更易耐受。据推测，这种新策略在改善终末期COPD患者的功能障碍及随之而来的残疾方面可能特别有效。
15例晚期COPD患者（9例男性）被随机分为两组，一组接受为期6周的居家股四头肌NMES训练计划（第1组，n = 9，第1秒用力呼气容积（FEV₁）为预测值的38.0（9.6）%），另一组在接受NMES之前有6周的对照期（第2组，n = 6，FEV₁为预测值的39.5（13.3）%）。评估了膝关节伸肌力量和耐力、全身运动能力以及健康相关生活质量（慢性呼吸系统疾病问卷，CRDQ）。
所有患者均能成功完成NMES训练计划，即使在病情加重的情况下（n = 4）。训练与肌肉功能、最大和耐力运动耐量以及CRDQ的呼吸困难领域显著改善相关（p < 0.05）。NMES后肌肉性能和运动能力的改善与经运动强度校正后的腿部用力感知降低密切相关（p < 0.01）。
对于因严重呼吸困难而重度残疾的COPD患者，对参与步行的选定下肢肌肉进行短期电刺激可改善肌肉力量和耐力、全身运动耐量以及日常生活活动中的呼吸急促症状。
