Program Development Centre, Ciro+, Hornerheide 1, Horn, The Netherlands.
Lung. 2011 Feb;189(1):21-6. doi: 10.1007/s00408-010-9265-0. Epub 2010 Nov 16.
Transcutaneous neuromuscular electrical stimulation (NMES) involves the application of an electrical current through electrodes placed on the skin over the targeted muscles. During high-frequency NMES (HF-NMES), oxygen uptake, minute ventilation, and the degree of symptom perception (dyspnea and fatigue) have been shown to be acceptable in chronic obstructive pulmonary disease (COPD). Currently, oxygen uptake and ventilation load have never been assessed during low-frequency NMES (LF-NMES) of the lower-limb muscles. The purpose of this study was to compare prospectively oxygen uptake, ventilation, and symptom perception during a single session of LF-NMES versus a single session of HF-NMES of quadriceps muscles in patients with COPD. In 17 COPD patients (mean FEV(1) = 45% predicted, mean body mass index = 26.2 kg/m(2)), peak exercise capacity, functional exercise capacity, and the Medical Research Council dyspnea grade were evaluated. In addition, oxygen uptake, minute ventilation, heart rate, and Borg symptom scores were assessed during one session of LF-NMES (15 Hz) and one session of HF-NMES (75 Hz) and compared with peak values. Mean oxygen uptake (LF-NMES: 327 ml/min vs. HF-NMES: 315 ml/min), minute ventilation (LF-NMES: 14 L vs. HF-NMES: 15 L), and heart rate (LF-NMES: 86 BPM vs. HF-NMES: 83 BPM) were similar during both NMES frequencies. Patients used a relatively low proportion of their peak aerobic capacity during both NMES sessions (LF-NMES: 34% vs. HF-NMES: 33%; P = 0.397). In addition, symptom Borg scores for dyspnea and leg fatigue were also comparable. Oxygen uptake, ventilation, and symptoms of dyspnea and fatigue were comparable and tolerable during LF-NMES and HF-NMES in patients with COPD. Therefore, LF-NMES and HF-NMES may both be suitable rehabilitative modalities to be used in severely dyspneic patients with lower-limb muscle dysfunction.
经皮神经肌肉电刺激（NMES）涉及将电流通过放置在目标肌肉上方皮肤的电极应用。在高频 NMES（HF-NMES）中，已经表明慢性阻塞性肺疾病（COPD）患者的氧气摄取量、分钟通气量和症状感知程度（呼吸困难和疲劳）可接受。目前，低频 NMES（LF-NMES）下肢肌肉的氧气摄取量和通气负荷从未被评估过。本研究的目的是前瞻性地比较 COPD 患者单次 LF-NMES 和单次 HF-NMES 股四头肌的氧气摄取量、通气和症状感知。在 17 名 COPD 患者（平均 FEV1 =预测值的 45%，平均体重指数 = 26.2 kg/m2）中，评估了峰值运动能力、功能运动能力和医学研究理事会呼吸困难等级。此外，在单次 LF-NMES（15 Hz）和单次 HF-NMES（75 Hz）期间评估了氧气摄取量、分钟通气量、心率和 Borg 症状评分，并与峰值值进行了比较。两种 NMES 频率下的平均氧气摄取量（LF-NMES：327 ml/min 与 HF-NMES：315 ml/min）、分钟通气量（LF-NMES：14 L 与 HF-NMES：15 L）和心率（LF-NMES：86 BPM 与 HF-NMES：83 BPM）相似。在两种 NMES 治疗期间，患者仅使用其峰值有氧能力的相对较低比例（LF-NMES：34%与 HF-NMES：33%；P = 0.397）。此外，呼吸困难和腿部疲劳的 Borg 症状评分也相似。在 COPD 患者中，LF-NMES 和 HF-NMES 期间的氧气摄取量、通气和呼吸困难和疲劳症状均相似且可耐受。因此，LF-NMES 和 HF-NMES 可能都是适合用于下肢肌肉功能障碍的严重呼吸困难患者的康复治疗方式。
