Gong Haihong, Jiang Qinghe, Shen Dongchao, Gao Jinming
Department of Respiratory Disease, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
Department of Respiratory Disease, Liaocheng People's Hospital, Liaocheng 252000, China.
J Thorac Dis. 2018 Dec;10(12):6722-6732. doi: 10.21037/jtd.2018.11.133.
Neuromuscular electrical stimulation (NMES) has been suggested as an alternative rehabilitative therapy to enhance exercise performance and skeletal muscle function in adult patients with chronic lung disease. However, the results of individual studies have been inconsistent. We performed a meta-analysis to evaluate the effectiveness of NMES with regard to increasing exercise capacity, quadriceps strength, muscle mass, cross-sectional area, and quality of life and decreasing dyspnea in adult patients with chronic lung disease.
A systematic search was conducted of the PubMed, Cochrane Library and EMBASE databases for randomized controlled trials (RCTs) published in English-language journals before January 2018. Data were extracted using standardized forms, and the weighted mean difference (WMD) or standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated.
Eleven RCTs involving 368 patients were included in this meta-analysis. The pooled results showed that NMES significantly improved the 6-min walk distance (WMD: 37.93 m, 95% CI: 19.53-56.33 m; P<0.0001; P for heterogeneity =0.11; I=47%) but not the incremental shuttle walk test (WMD: 18.18 m, 95% CI: -79.41 to 115.77 m, P=0.72; P for heterogeneity <0.0001, I=94%) or endurance shuttle walk test (ESWT) (WMD: 96.73 m, 95% CI: -45.58 to 239.03 m, P=0.18; P heterogeneity =0.22, I=34%). Moreover, NMES was associated with a significant improvement in quadriceps strength (SMD: 1.14, 95% CI: 0.86-1.43, P<0.00001; P heterogeneity =0.02, I=58%).
This systemic review and meta-analysis provided evidence supporting the beneficial role of NMES in improving exercise capacity in patients with chronic respiratory disease.
神经肌肉电刺激（NMES）已被提议作为一种替代康复疗法，以提高慢性肺病成年患者的运动能力和骨骼肌功能。然而，个别研究的结果并不一致。我们进行了一项荟萃分析，以评估NMES在提高慢性肺病成年患者运动能力、股四头肌力量、肌肉质量、横截面积和生活质量以及减轻呼吸困难方面的有效性。
对PubMed、Cochrane图书馆和EMBASE数据库进行系统检索，查找2018年1月之前发表在英文期刊上的随机对照试验（RCT）。使用标准化表格提取数据，并计算加权平均差（WMD）或标准化平均差（SMD）以及95%置信区间（CI）。
本荟萃分析纳入了11项涉及368例患者的RCT。汇总结果显示，NMES显著改善了6分钟步行距离（WMD：37.93米，95%CI：19.53 - 56.33米；P<0.0001；异质性P = 0.11；I² = 47%），但未改善递增往返步行试验（WMD：18.18米，95%CI：-79.41至115.77米，P = 0.72；异质性P<0.0001，I² = 94%）或耐力往返步行试验（ESWT）（WMD：96.73米，95%CI：-45.58至239.03米，P = 0.18；异质性P = 0.22，I² = 34%）。此外，NMES与股四头肌力量的显著改善相关（SMD：1.14，95%CI：0.86 - 1.43，P<0.00001；异质性P = 0.02，I² = 58%）。
这项系统评价和荟萃分析提供了证据，支持NMES在改善慢性呼吸道疾病患者运动能力方面的有益作用。
