SESSION TITLE: Physiology/PFTs/Rehabilitation
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Tuesday, October 28, 2014 at 08:45 AM - 10:00 AM
PURPOSE: The aim of this study is to determine the efficacy of low frequency NMES + Pulmonary Rehabilitation which has not been established in all stages of COPD (mild to very severe) and determine the impact on dyspnea, health status, muscle hypertrophy, endurance, exercise capacity, quality of life and life expectancy.
METHODS: Quality of life(SGRQ) and Life Expectancy(BODE Index):primary outcomes.FEV1, FEV1/FVC, Dyspnea(Modified Medical Research Council Dyspnea scale), health status(CAT), muscle hypertrophy(Quadriceps circumference),endurance(sit-to-stand-test) and exercise capacity(6MWT):secondary outcomes measured after 1month and 2months of intervention. Patients were subjected to low frequency (9Hz) continuous current of NMES applied over the quadriceps for 30 minutes in addition to Pulmonary Rehabilitation done 3x a week.
RESULTS: A Prospective study done in 5 months, were 19 COPD patients were included, 17(89.47)males with a mean age of 68. 11(57.89) patients finished 24 sessions and 7(36.84) for 12 sessions.Post-bronchodilator FEVI 13(68.42) severe, 3(15.79) moderate and 2(10.53) very severe;COPD C 4(21.05) and COPD D 15(79.94).BMI: underweight 10(52.63) and 6(31.58)normal.Average MUAC 230±30.4. No improvement in post-brochodilator FEV1(p<0.5848) and (p< 0.4470) and FEV1/FVC (p<0.1316) and (p=0.3582). After the 1st month of NMES+PR there was significant improvement(p<0.0001):MMRC ,STST,6MWT, SGRQ and Bode Index(p=0.0087). It was only at the second month that Quadriceps circumference (p=0.0002),and CAT scores (p=0.0039) showed significant change.
CONCLUSIONS: The combination of low frequency NMES+ PR 3x a week for 2 months showed a significant effect on dyspnea score, health status, muscle hypertrophy, endurance, exercise capacity and ultimately quality of life and life expectancy. However, there was no effect in ventilatory defect in terms FEV1 and FEV1/FVC.
CLINICAL IMPLICATIONS: NMES can be used in conjunction with the Pulmonary Rehabilitation and is beneficial to all stages of COPD.
DISCLOSURE: The following authors have nothing to disclose: Angelene Taleon-Parazo, Bernice Ong-Dela Cruz
NMES has been used as an adjunct in Rehabilitation, however there is no current protocol on low frequency NMES in COPD patients.