Home-based Neuromuscular Electrical Stimulation as an Add-on to Pulmonary Rehabilitation Does Not Provide Further Benefits in Patients With Chronic Obstructive Pulmonary Disease: A Multicenter Randomized Trial

Effects of neuromuscular electrical stimulation on exercise capacity and quality of life in COPD patients: a systematic review and meta-analysis

“…Although both studies included in this meta-analysis showed the different direction of effect, this analysis had no statistical heterogeneity (I 2 = 0%). In the study conducted by Bonnevie et al, the PR alone led to a mean improvement of VO 2 peak after rehabilitation (15.8 ml/kg/min; P=0.04) [6]. When we excluded this study, the MD from the remaining four studies was 61.57 (95% CI: −30.63 to 153.78; participants = 73), but the difference was not significant.…”

“…After excluding the study by Bonnevie et al [6], the pooled MD was 5.77 (95% CI: −6.00 to 17.53; participants = 33), indicating favoring the NMES group. It was suggested that the control group demonstrated an improvement in VO 2 peak compared with NMES group (MD: −1.09, 95% CI: −2.10 to −0.08; P=0.03), as shown in Figure 4.…”

“…This comparison allowed us to determine the effects of NMES in isolation from other exercise rehabilitation strategies. On the other hand, six studies compared NMES plus conventional exercise training versus exercise training alone, with or without sham training NMES [6,14,18,19,34,35]. This comparison allowed us to determine the effects of using NMES as an adjunct to conventional PR.…”

“…In recent decades, most consistent findings of NMES training have supported the beneficial effects on COPD patients, lately, Bonnevie et al have revealed that unsupervised home-based NMES as an add-on to PR does not further improve benefits in subjects with severe to very severe COPD [6]. What is worse, it might be a burden for some subjects.…”

Add‐on interventions during pulmonary rehabilitation

“…Only a few studies, including mostly small sample sizes, investigated this topic and reported inconclusive results. One study found a significant larger improvement in 6MWD in favour of a supplemental NMES usage, two studies concluded that NMES did not result in further improvements and one study reported even a less pronounced benefit from PR when additional NMES was applied . For the future, a more systematic approach to NMES therapy is needed including a comprehensive assessment of the patients' individual impairments, identifying responders to NMES therapy and ideally developing an algorithm for NMES indication and training settings.…”