Saturday, July 18, 2009

Electrical Muscular Stimulation May Have Role in Rehab

Technology has promise for patients with heart failure or COPD who cannot tolerate exercise

18 july 2009-- Transcutaneous neuromuscular electrical stimulation (NMES) may help improve endurance and muscular fitness in patients with congestive heart failure and chronic obstructive pulmonary disease (COPD) who cannot exercise strenuously, according to a literature review in the July issue of Chest.

Maurice J.H. Sillen, P.T., of the Center for Integrated Rehabilitation of Organ Failure in Horn, Netherlands, and colleagues reviewed the medical literature on NMES. The reviewers screened 208 studies and identified 14 relevant trials, including nine that examined use of the technology in congestive heart failure patients, and five in COPD patients.

The studies on congestive heart failure patients variously reported significant increases in peak workload, peak oxygen uptake, muscle strength, and health status on the Medical Outcomes Study 36-item short form, as well as decreased fatigue with NMES. However, in five studies, the effect of NMES was not significantly better than endurance training. For COPD, NMES also had significant benefits generally, but one study found it no better than sham stimulation, and another found no improvement in the six-minute walking distance test compared to usual rehabilitation.

"Nonetheless, the limited number of studies, the disparity in patient populations, and the variability in NMES methodology prohibit the use of meta-analysis. Yet, from the viewpoint of a systematic review, NMES looks promising as a means of rehabilitating patients with congestive heart failure and COPD. There is at least sufficient evidence to warrant more large prospective, randomized, controlled trials," the authors conclude.

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