Original research| Volume 99, ISSUE 8, P1462-1470, August 2018

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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

Published:February 17, 2018DOI:



      To assess the additional effect of a home-based neuromuscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD).


      Single-blind, multicenter randomized trial.


      Three PR centers.


      Subjects with severe to very severe COPD (N=73; median forced expiratory volume in 1 second, 1L (25th–75th percentile, 0.8–1.4L) referred for PR. Twenty-two subjects discontinued the study, but only 1 dropout was related to the intervention (leg discomfort).


      Subjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, 5 time per week) or PR without NMES for 8 weeks.

      Main Outcome Measure

      The 6-minute walk test (6MWT) was used to assess functional capacity.


      Eighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (P<.01), peak oxygen consumption (P=.02), maximal workload (P<.01), modified Medical Research Council dyspnea scale (P<.01), and Saint George’s Respiratory Questionnaire total score (P=.01). There was no significant difference in the magnitude of change for any outcome between groups.


      Home-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD; moreover, it may have been a burden for some patients.


      List of abbreviations:

      BMI (body mass index), COPD (chronic obstructive pulmonary disease), CPET (cardiopulmonary exercise testing), NMES (neuromuscular electrical stimulation), PR (pulmonary rehabilitation), QoL (quality of life), SGRQ (Saint George’s Respiratory Questionnaire), 6MWT (6-minute walk test), V˙o2 (oxygen consumption), Vo2peak (peak oxygen consumption)
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