Department of Physical Therapy, School of Health Sciences, University of Granada, Granada, Spain.
Department of physiotherapy, University of Miami, Coral Gables, FL, USA.
Physiother Theory Pract. 2021 Dec;37(12):1360-1367. doi: 10.1080/09593985.2019.1694611. Epub 2019 Nov 26.
Pulmonary rehabilitation is an effective intervention for individuals who have Chronic Obstructive Pulmonary Disease (COPD). The adequate intensity, components, and number of sessions are difficult to determine, specifically in patients who have severe ventilatory limitations in order to produce true physiological training effects without adverse events. Our aim is to assess the feasibility and possible effects of a daily versus a twice-daily functional electrostimulation program in hospitalized individuals who have a severe COPD. In this randomized controlled trial, 48 severe patients with COPD were randomized into three groups: Control Group (CG; n = 16), daily functional electrostimulation group (DFEG; n = 15) or twice-daily functional electrostimulation group (TFEG; n = 17). The main outcome measures were quadriceps strength, symptoms at rest and after exercise, and adverse events measured before and after the intervention. After eight sessions, DFEG and TFEG showed significant differences when compared to the CG in all measured variables at discharge ( ≤ .001), no adverse events were observed in any of the treatment groups. Significant improvements were found in strength ( ≤ .05) between DFEG and TFEG groups. However, lower limb function did not present significant differences in spite of the fact that the mean change favored the TFEG (23.53 ± 3.53 vs. 19.56 ± 11.89). Further examination of twice per day functional electrostimulation in hospitalized patients with COPD with acute exacerbation appears warranted.
肺康复是治疗慢性阻塞性肺疾病(COPD)患者的有效干预措施。然而,对于那些存在严重通气限制的患者,确定适当的强度、组成和疗程数量是很困难的,因为这可能会产生真正的生理训练效果而不会产生不良反应。我们的目的是评估每日与每日两次的功能性电刺激方案在住院的严重 COPD 患者中的可行性和可能效果。在这项随机对照试验中,将 48 名严重 COPD 患者随机分为三组:对照组(CG;n = 16)、每日功能性电刺激组(DFEG;n = 15)或每日两次功能性电刺激组(TFEG;n = 17)。主要观察指标为股四头肌力量、静息和运动后症状以及干预前后的不良反应。经过 8 个疗程后,DFEG 和 TFEG 在出院时与 CG 相比,所有测量变量均有显著差异(≤.001),在任何治疗组中均未观察到不良反应。DFEG 和 TFEG 组在力量方面均有显著改善(≤.05)。然而,尽管 TFEG 组的平均变化更有利(23.53 ± 3.53 对 19.56 ± 11.89),但下肢功能并未表现出显著差异。进一步研究在 COPD 急性加重的住院患者中每日两次的功能性电刺激似乎是合理的。