0
Original Research: COPD |

Improvement in Quadriceps Strength and Dyspnea in Daily Tasks After 1 Month of Electrical Stimulation in Severely Deconditioned and Malnourished COPD*

Isabelle Vivodtzev, MSc; Jean-Louis Pépin, MD, PhD; Gabrielle Vottero, MD; Valerie Mayer, MD; Bernard Porsin, MD; Patrick Lévy, MD, PhD; Bernard Wuyam, MD, PhD
Author and Funding Information

*From the Lung function and Exercise Laboratory (Ms. Vivodtzev, and Drs. Pépin, Lévy, and Wuyam), Hospital A Michallon, Grenoble, France; and the Pulmonary Rehabilitation Center (Drs. Vottero, Mayer, and Porsin) Les Rieux, Nyons, France.

Correspondence to: Bernard Wuyam, MD, PhD, EFCR, BP 217 X, 38043 Grenoble, France; e-mail: BWuyam@chu-grenoble.fr



Chest. 2006;129(6):1540-1548. doi:10.1378/chest.129.6.1540
Text Size: A A A
Published online

Study objectives: Low body weight in COPD patients is associated with worsening dyspnea, reduced leg strength, and poor prognosis. Classical rehabilitation strategies are then limited by reduced exercise tolerance. Thus, we proposed to evaluate whether electrostimulation (ES) was a beneficial technique in the rehabilitation programs for severely deconditioned COPD patients after an acute exacerbation.

Design: Randomized, controlled study.

Setting: Pulmonary rehabilitation center.

Patients: Seventeen patients with severe COPD (mean [ ± SD] FEV1, 30 ± 3% predicted) and low body mass index (BMI) [18 ± 2.5 kg/m2].

Methods: Patients were randomly assigned either to usual rehabilitation (UR) alone or to a UR-plus-ES program for 4 weeks. Quadriceps muscle strength, total muscle mass (MM), exercise capacity, and health-related quality of life were measured before and after rehabilitation.

Results: The training with ES plus UR induced a significant twofold improvement in the mean number of maximal voluntary contraction (MVC) compared to UR alone (97 ± 71 vs 36 ± 34 contractions, respectively; p = 0.03) and resulted in a more significant improvement in dyspnea when performing daily tasks (decrease in the dyspnea domain score of the 28-item Maugeri Foundation Respiratory Failure questionnaire, −1.7 ± 1.0 vs −0.2 ± 1.2 points, respectively; p = 0.05). There was also a significant increase in walking distance (63 ± 40 m; p = 0.01) and BMI (0.6 ± 0.5 kg/m2; p = 0.02) after training in the ES + UR group. A significant relationship was found between changes in MVC and changes in MM after training in the ES + UR group (r = 0.94; p = 0.03).

Conclusions: The combination of ES and UR was associated with greater improvement in quadriceps strength and dyspnea during the performance of daily tasks than UR alone in severely disabled COPD patients with low BMI. In this population, ES has been revealed as a useful procedure, complementing the usual pulmonary rehabilitation.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543