Authors (including presenting author) :
Lam KHM, Tsui AYY, Kong ISY, Cheng HKY, Chou KCH, Wong KKY, Leung KKL
Affiliation :
Physiotherapy Department, Kowloon Hospital
Introduction :
Muscle dysfunction, defined as the loss of either strength or endurance properties of muscles, is a major co-morbidity in chronic respiratory diseases that causes impaired patients’ exercise capacity and poor quality of life. Progressive resistance training is an essential component in an exercise program to improve muscle strength and associated functional capacity. Functional electrical stimulation(FES) combined neuromuscular stimulation to one or more muscles and progressive resistance training with functional movement demonstrated significant improvement in physiological response during exercise in single treatment session. Cumulative effect may gain additional benefit when incorporated in the pulmonary rehabilitation program(PRP) for patients with chronic respiratory diseases.
Objectives :
To evaluate the additional benefit of quadriceps FES for patients with chronic respiratory diseases in pulmonary rehabilitation program.
Methodology :
This is a prospective cohort study with comparison to age-matched historical control. Patients in FES group and control group participated in the routine PRP with a total of 16 training sessions. Both groups participated in 1.5 hours training program consisted of (1) 15 minutes warm-up and cool down exercises (2) 60 minutes multi-modal training including aerobic exercises, strengthening exercises and functional training. In FES group, patients performed lower limbs cycling exercise with additional FES to bilateral quadriceps for 15 minutes during circuit training. Intervention effect was evaluated by 6-mimutes walk test(6MWT), incremental cycle exercise test(ICET), rate of perceived dyspnoea(RPD), quadriceps strength, skeletal muscle mass(SMM) and St. George Respiratory Questionnaire(SGRQ).
Result & Outcome :
Since May 2024, 14 PRP participants were recruited to the FES group. Both FES group and control group exhibited improvement in 6MWT distance[336.21±114.09m to 384.07±95.17m vs 296.64±80.12m to 336.79±75.89m], activity level in ICET[2.91±1.27MET to 2.96±1.27METS vs 2.18±0.89MET to 2.41±0.99MET], quadriceps strength[15.53±4.59lbs to 17.81±4.12lbs vs 15.70±4.35lbs vs 16.04 ±4.43lbs] and SMM[22.39±4.15kg to 23.04±4.57kg vs 22.17±4.56kg to 22.69±4.12kg]. In addition, FES group demonstrated significant better improvement in RPD during ICET[3.79±1.53 to 2.71 ±0.61 vs 3.29±1.38 to 3.00±1.04] and SGRQ total scores[44.97±22.14 to 28.86± 18.91 vs 44.20±3.77 to 39.20±12.97] with significant level at p<0.05. Exertional dyspnoea is the major limiting factor to activities of daily living which leads to a vicious cycle of avoidance of physical activities and gradual decline in exercise tolerance. Regular PRP incorporated FES further reduces exertional dyspnoea during activities, enhances the quality of life and self-care of the patients with chronic respiratory diseases.
