Kaymaz Dicle, Ergün Pınar, Demirci Ebru, Demir Neşe
Department of Pulmonary Rehabilitation and Home Care Center, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
Tuberk Toraks. 2015;63(1):1-7. doi: 10.5578/tt.8493.
In severely disabled patients who are not capable of following formal pulmonary rehabilitation (PR) and/or tolerating higher training intensities, neuromuscular electrical stimulation (NMES) has been successfully utilized as a localized training method.
In this non-randomized controlled observational study 50 patients with severe chronic obstructive pulmonary disease (COPD), who were allocated into two groups. Endurance training group (ET) (n= 27) and NMES group (n= 23). To compare the effects of NMES and ET on health-related quality of life (HRQOL), exercise capacity, muscle strength, dyspnea, psychological status, and body composition in patients with severe COPD. Before and after PR program, the study parameters were assessed using the Medical Research Council (MRC) scale, incremental and endurance shuttle walking tests (ISWT, ESWT), manual muscle testing (MMT), the St. George's Respiratory Questionnaire (SGRQ), bioelectrical impedance analysis, and the Hospital Anxiety and Depression Scale (HADS).
After the PR program, walking distance and endurance time significantly increased in both groups (p< 0.001 for each), whereas the MRC scores of both groups significantly decreased (p< 0.001 for each). In the ET group, significant decreases were noted in all domains of SGRQ and HADS. In the NMES group, significant improvements were observed in the HADS scores and in all SGRQ domain except symptom domain. No significant differences were observed between the NMES and ET groups regarding the changes from baseline to after PR program in walking distance (p= 0.140), endurance time (p= 0.376), the MRC (p= 0.540), HRQOL (p> 0.05) and HADS (p> 0.05) scores, body-mass index (BMI) (p= 0.49), fat-free mass (FFM) (p= 0.50) and fat-free mass index (FFMI) (p= 0.94).
NMES can be used as an effective treatment strategy in PR programs for peripheral muscle training in patients with severe COPD.
在无法进行正规肺康复（PR）和/或耐受更高训练强度的严重残疾患者中，神经肌肉电刺激（NMES）已成功用作一种局部训练方法。
在这项非随机对照观察性研究中，50例重度慢性阻塞性肺疾病（COPD）患者被分为两组。耐力训练组（ET）（n = 27）和NMES组（n = 23）。为比较NMES和ET对重度COPD患者健康相关生活质量（HRQOL）、运动能力、肌肉力量、呼吸困难、心理状态和身体成分的影响。在PR计划前后，使用医学研究委员会（MRC）量表、递增和耐力穿梭步行试验（ISWT、ESWT）、徒手肌力测试（MMT）、圣乔治呼吸问卷（SGRQ）、生物电阻抗分析和医院焦虑抑郁量表（HADS）评估研究参数。
PR计划后，两组的步行距离和耐力时间均显著增加（每组p < 0.001），而两组的MRC评分均显著降低（每组p < 0.001）。在ET组中，SGRQ和HADS的所有领域均显著下降。在NMES组中，HADS评分以及除症状领域外的所有SGRQ领域均有显著改善。在从基线到PR计划后的步行距离（p = 0.140）、耐力时间（p = 0.376）、MRC（p = 0.540）、HRQOL（p > 0.05）和HADS（p > 0.05）评分、体重指数（BMI）（p = 0.49）、去脂体重（FFM）（p = 0.50）和去脂体重指数（FFMI）（p = 0.94）的变化方面，NMES组和ET组之间未观察到显著差异。
NMES可作为重度COPD患者PR计划中用于外周肌肉训练的有效治疗策略。
