Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .
Improvement in quadriceps strength and dyspnea in daily tasks after 1 month of electrical stimulation in severely deconditioned and malnourished COPD.
STUDY OBJECTIVES Low body weight in COPD patients is associated with worsening dyspnea , reduced leg strength , and poor prognosis . Classical rehabilitation strategies are then limited by reduced exercise tolerance . Thus , we proposed to evaluate whether electrostimulation ( ES ) was a beneficial technique in the rehabilitation programs for severely deconditioned COPD patients after an acute exacerbation . DESIGN R and omized , controlled study . SETTING Pulmonary rehabilitation center . PATIENTS Seventeen patients with severe COPD ( mean [ + /- SD ] FEV(1 ) , 30 + /- 3 % predicted ) and low body mass index ( BMI ) [ 18 + /- 2.5 kg/m(2 ) ] . METHODS Patients were r and omly assigned either to usual rehabilitation ( UR ) alone or to a UR-plus-ES program for 4 weeks . Quadriceps muscle strength , total muscle mass ( MM ) , exercise capacity , and health-related quality of life were measured before and after rehabilitation . RESULTS The training with ES plus UR induced a significant twofold improvement in the mean number of maximal voluntary contraction ( MVC ) compared to UR alone ( 97 + /- 71 vs 36 + /- 34 contractions , respectively ; p = 0.03 ) and result ed in a more significant improvement in dyspnea when performing daily tasks ( decrease in the dyspnea domain score of the 28-item Maugeri Foundation Respiratory Failure question naire , -1.7 + /- 1.0 vs -0.2 + /- 1.2 points , respectively ; p = 0.05 ) . There was also a significant increase in walking distance ( 63 + /- 40 m ; p = 0.01 ) and BMI ( 0.6 + /- 0.5 kg/m(2 ) ; p = 0.02 ) after training in the ES + UR group . A significant relationship was found between changes in MVC and changes in MM after training in the ES + UR group ( r = 0.94 ; p = 0.03 ) . CONCLUSIONS The combination of ES and UR was associated with greater improvement in quadriceps strength and dyspnea during the performance of daily tasks than UR alone in severely disabled COPD patients with low BMI . In this population , ES has been revealed as a useful procedure , complementing the usual pulmonary rehabilitation
Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .