Effects of high-frequency neuromuscular electrostimulation with external weights in patients with chronic obstructive pulmonary disease with severe symptoms of shortness of breath and dysfunction of lower extremity muscles: a pilot effects study.

Chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,
COPD) is a major and growing cause of morbidity and mortality worldwide (1).
Despite optimal drug treatment of respiratory tract obstruction, shortness of
breath, reduction of exercise capacity, fatigue and decreased disease-specific
quality of life (KvL) are the most reported problems (2). COPD is a lung
disease with significant manifestations outside the lungs that can contribute
to the severity of the problems (3). These manifestations are also called
systemic effects of COPD, including an abnormal loss of muscle mass and
decreased muscle function (4). Patients with COPD are characterized by a loss
of maximum muscle strength and decreased stamina of the muscular quadriceps
femoris (5-7). A relationship has been shown between decreased peripheral
muscle strength and muscle mass depletion with decreased exercise tolerance in
COPD patients, regardless of the degree of airway obstruction (8, 9). Muscular
loss of the muscular quadriceps femoris (4-headed femoral vein) contributes
significantly to the decreased efforts, increased use of healthcare and
mortality in COPD (9-11). Muscle weakness of the leg muscles has been
demonstrated in the lower extremities of patients with COPD (12), which leads
to a downward spiral of deconditioning. Shortness of breath leads to a seated
lifestyle and deconditioning of the muscles that make the movement, and thus to
further inactivity (13).

The aim of this study is to determine whether external weights affect the
intensity of NMES and the possible effects on metabolic processes and muscle
activity in COPD patients.

It is a pilot study with crossover design.

NMES will be applied to the patient without the addition of external weights.
The muscles are stimulated with a frequency of 75 Herz and a pulse duration of
400 microseconds. The intensity is increased by the patient to the tolerance
limit. Patients are verbally motivated to increase the intensity as much as
possible. During the NMES, metabolic load and muscle activation are measured.
The metabolic load is measured by means of a mobile oxycon. The muscle activity
will be monitored by means of an EMG measurement. These measurements will be
measured both at the start and at the end of the treatment. During the tests it
is necessary that the intervention is still ongoing.

Not applicable