Effectiveness of Neuromuscular Electrical Stimulation on Auxiliary Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease Treated in the Intensive Care Unit

Abstract

Objective: Chronic obstructive pulmonary disease is a major public health problem. In the present study, we aimed to investigate the possible effects of upper extremity exercises and neuromuscular electrical stimulation therapy applied to auxiliary respiratory muscles on arterial blood gases, blood pressure, heart rate values, and quality of life in patients with chronic obstructive pulmonary disease. Material and Methods: Thirty patients who were diagnosed with stage 4 severe chronic obstructive pulmonary disease by a pulmonologist and who needed intensive care were included in the study. The patients were equally allocated into two groups containing 15 patients each: control and intervention. Both groups were given an unassisted upper extremity exercise program for four weeks, and only one group was given neuromuscular electrical stimulation on auxiliary respiratory muscles for 10 days. Arterial blood gas measurements, peak heart rate, and breathing frequency were recorded. St. George's Respiratory Questionnaire and short form-36 were performed for the evaluation of the quality of life. Functional capacity was determined by functional independent measurement. Evaluations of the patients were performed on the 1 st , 8 th , 15 th , and 30 th days of the study. Results: There were statistically significant improvements in peak heart rate, breathing frequency per minute, and functional independency scores in the group where exercise and neuromuscular electrical stimulation had been concomitantly applied (p<0.05). Conclusion: This study revealed positive effects of neuromuscular electrical stimulation in addition with therapeutic exercises on the cardiorespiratory system in the short run.

Physical rehabilitation interventions in the intensive care unit: a scoping review of 117 studies

“…Of 81 single interventions, NMES occurred in 17 (21.0%), with 14 of these (82.3%) being RCTs. Of the NMES studies, 16 (94.2%) studies targeted the lower extremity muscles, 1 also included biceps [ 25 ], and 1 studied accessory respiratory muscles [ 26 ]. Start times for the interventions varied from 1 [ 27 , 28 ] up to 4.6 days [ 29 ] after ICU admission with intervention duration varying from a single session [ 30 ] up to 4 weeks after initiation [ 31 ].…”

“…Start times for the interventions varied from 1 [ 27 , 28 ] up to 4.6 days [ 29 ] after ICU admission with intervention duration varying from a single session [ 30 ] up to 4 weeks after initiation [ 31 ]. Three studies did not report information on the intervention start time [ 26 , 28 , 30 ].…”

Efficacy of neuromuscular electrical stimulation in patients with COPD followed in intensive care unit

“…Koçan Kurtoğlu et al . evaluated the effectiveness of NMES in patients with COPD treated in the ICU . They did not found any significant differences in terms of weaning duration between NMES applied group and control.…”

“…Symmetrical biphasic square waves with 6 s duration of contraction, 1.5 s of increase and 0.75 s of decrease were applied. The wave frequency was 50 Hz . Both visible and palpable muscle contractions were obtained during NMES.…”

Functional electrical stimulation-assisted cycle ergometry in the critically ill: protocol for a randomized controlled trial

“…For example, physical exercise can be delivered effectively and safely by passive supine cycling on a bicycle ergometer [15, 18, 28–30]. More recently, electrical neuromuscular stimulation (NMES) has been developed to mimic active exercise in patients who lack voluntary muscle activity [31–39]. During NMES, cutaneous electrodes placed over specific muscle groups electrically trigger muscle contractions.…”