Quadriceps electrical stimulation as an adjunct to pulmonary rehabilitation: a pilot randomised controlled trial

<bold>Introduction:</bold> Both pulmonary rehabilitation (PR) and neuromuscular electrical stimulation (NMES) are interventions that improve exercise capacity, muscle dysfunction and health status in patients with COPD. However evidence exploring synergistic effects are limited. <bold>Aim:</bold> To assess the effectiveness of NMES as an adjunct to PR. We hypothesised that NMES of the quadriceps would improve cycling endurance and quadriceps strength more than sham NMES alongside an 8 week PR programme. <bold>Methods:</bold> Design: Parallel, two-group, placebo-controlled, double-blind, randomised study; Participants: COPD, evidence of quadriceps weakness, undergoing an 8 week PR programme; Intervention: Daily active NMES of both quadriceps; Control: Sham NMES of both quadriceps; Outcomes: Primary: Constant work-rate cycle endurance time (CET), Secondary: Walking exercise capacity (ESW), six minute step test (6MST), quadriceps strength (QMVC), short performance battery (SPPB), COPD Assessment Test (CAT) <bold>Results:</bold> Of 346 screened, 103 were eligible, and 31 randomised (Intervention: n=15; Control: n=16). No significant between group differences in change from baseline to 8 weeks in CET, ESW, 6MST, QMVC, SPPB, CAT (Figure 1). <bold>Conclusion:</bold> Based on SD of the control group, 1432 patients would be required to have a 90% chance of detecting, as significant at the 5% level, an increase of 60 seconds in CET with active NMES, which was deemed unfeasible. <fig><object-id>erj;66/suppl_69/PA2666/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>