Original research| Volume 99, ISSUE 8, P1454-1461, August 2018

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Functional Electrical Stimulation—A New Therapeutic Approach to Enhance Exercise Intensity in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Crossover Trial

Published:March 07, 2018DOI:



      To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake ( V ˙ o2) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD).


      A randomized, single-blind, placebo-controlled crossover trial.


      Pulmonary rehabilitation department.


      Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1.4±0.4L [50.3% predicted]) who had recently begun a respiratory rehabilitation program.


      Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-cycling.

      Main Outcome Measures

      The primary outcome was mean V ˙ o2 during the 30-minute exercise session. The secondary outcomes were respiratory gas exchange and hemodynamic parameters averaged over the 30-minute endurance session. Lactate values, dyspnea, and perceived muscle fatigue were evaluated at the end of the sessions.


      FES-cycling increased the physiological response more than the placebo, with a greater V ˙ o2 achieved of 36.6mL/min (95% confidence interval [CI], 8.9–64.3mL/min) (P=.01). There was also a greater increase in lactate after FES-cycling (+1.5mmol/L [95% CI, .05–2.9mmol/L]; P=.01). FES-cycling did not change dyspnea or muscle fatigue compared with the placebo condition.


      FES-cycling effectively increased exercise intensity in patients with COPD. Further studies should evaluate longer-term FES-cycling rehabilitation programs.


      List of abbreviations:

      CI (confidence interval), COPD (chronic obstructive pulmonary disease), FES (functional electrical stimulation), TENS (transcutaneous electrical nerve stimulation), V˙co2 (carbon dioxide production), V˙e (minute ventilation), V˙o2 (oxygen uptake), Vo2peak (peak oxygen uptake)
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