Crowe Louis, Caulfield Brian
Institute of Sport and Health, Newstead Building, University College Dublin, Dublin, Ireland.
BMJ Open. 2012 Jun 14;2(3). doi: 10.1136/bmjopen-2011-000219. Print 2012.
A new generation of neuromuscular electrical stimulation (NMES) devices can exercise aerobically at equivalent rates to voluntary exercise. Many with type 2 diabetes cannot or will not exercise sufficiently. The objective of this pilot investigation was to see (1) if it was an acceptable training modality for men with type 2 diabetes mellitus and (2) to assess effects on haemoglobin A1c levels.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTION: A case series of eight men with type 2 diabetes mellitus (aged 53±8; body mass index 32±5 5 kg/m(2)) trained with the NMES system for 1 h 6 times weekly for 8 weeks, unsupervised, at home. There were no other medication or lifestyle interventions. The aerobic NMES exercise system delivers a repeating set of four complex staggered pulses at high intensities (typically 100 mA+) through an array of eight thigh electrodes.
The primary outcome measures were changes in haemoglobin A1c and the responses in a questionnaire on participants' perceptions of the system. Body mass and composition were also measured before and after the NMES intervention period.
All participants could use the system at a level that left them breathless and sweaty and with a heart rate over 120 beats per minute. Haemoglobin A1c levels improved by 0.8±0.7% from 7.4±1.3% (mean ± SD) to 6.6±1.0% (p=0.01). All participants considered the system suitable for people with diabetes, would recommend it and would continue to use it twice a week 'to maintain improvements'.
These results suggest that aerobic NMES may be acceptable and have a beneficial effect on haemoglobin A1c of some men with diabetes. The treatment may be of particular benefit in those who will not or cannot do adequate amounts of voluntary exercise. A randomised control trial is required for conclusive efficacy data.
新一代神经肌肉电刺激（NMES）设备能够以与自主运动相当的速率进行有氧运动。许多2型糖尿病患者无法或不愿进行足够的运动。这项初步调查的目的是：（1）确定它是否是2型糖尿病男性患者可接受的训练方式；（2）评估其对糖化血红蛋白水平的影响。
设计、地点、参与者和干预措施：对8名2型糖尿病男性患者（年龄53±8岁；体重指数32±5.5kg/m²）进行病例系列研究，他们在家中接受无监督的NMES系统训练，每周6次，每次1小时，共8周。未进行其他药物或生活方式干预。有氧NMES运动系统通过一组8个大腿电极，以高强度（通常为100mA以上）传递一组重复的四个复杂交错脉冲。
主要观察指标为糖化血红蛋白的变化以及参与者对该系统看法的问卷调查结果。在NMES干预期前后还测量了体重和身体成分。
所有参与者都能以使他们气喘吁吁、出汗且心率超过每分钟120次的强度使用该系统。糖化血红蛋白水平从7.4±1.3%（均值±标准差）改善至6.6±1.0%，改善了0.8±0.7%（p=0.01）。所有参与者都认为该系统适合糖尿病患者，会推荐它，并会继续每周使用两次“以维持改善效果”。
这些结果表明，有氧NMES可能是可接受的，并且对一些糖尿病男性患者的糖化血红蛋白有有益影响。对于那些不愿或不能进行足够量自主运动的患者，这种治疗可能特别有益。需要进行随机对照试验以获得确凿的疗效数据。
