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ORIGINAL PAPER
Impact of combined Russian current and threshold PEP on dyspnoea and functional capacity in patients with COPD: a randomised controlled trial
1
Internal Medicine Department, Faculty of Physical Therapy, Cairo University, Giza, Egypt
2
Chest Disease Department, Faculty of Medicine, Cairo University, Giza, Egypt
Submission date: 2022-04-13
Acceptance date: 2022-08-25
Publication date: 2024-03-25
Corresponding author
Ebtesam N. Nagy
Internal Medicine Department, Faculty of Physical Therapy, Cairo University, 7 Ahmed El zyat St., Dokki, Giza, Egypt, P.O.11432
Internal Medicine Department, Faculty of Physical Therapy, Cairo University, 7 Ahmed El zyat St., Dokki, Giza, Egypt, P.O.11432
Physiother Quart. 2024;32(1):50-56
KEYWORDS
chronic obstructive pulmonary diseasedyspnoeaexercise tolerancerespiratory muscle weaknessRussian current
TOPICS
ABSTRACT
Introduction:
Expiratory muscle weakness and dyspnoea are common in patients suffering from chronic obstructive pulmonary disease (COPD) and negatively affect their exercise capacity. We aimed to highlight the combined effect of Russian current and a threshold positive expiratory pressure (PEP) device on expiratory muscle strength, dyspnoea, and functional capacity in patients with COPD.
Methods:
A total of 60 males with COPD were involved in this controlled randomised trial (age ranged 55–65 years and median body mass index [BMI] was 28.68–25.96) and randomly assigned into two equal groups (30 for each), to receive combined Russian current and PEP device (study group) or PEP device only (control group), for three sessions per week over a ten-week period. Maximum expiratory pressure (MEP), dyspnoea (modified Borg scale – MBS), and functional capacity (6-minute walk test) were assessed before and after the intervention.
Results:
There was statistically significant improvement in all measured variables (MEP, MBS, and 6-minute walk test) in either the study group or the control group according to Wilcoxon’s sign rank test (all were p < 0.001 and p < 0.01, respectively), however, the study group showed a more significant improvement compared to the control group according to the Mann–Whitney U-test (p < 0.001).
Conclusions:
Combined Russian current and PEP device had a superior beneficial effect on improving dyspnoea and functional capacity by boosting the expiratory muscle strength in COPD patients, which could be implemented in their management, although further studies are needed to evaluate its maintenance effect.
Expiratory muscle weakness and dyspnoea are common in patients suffering from chronic obstructive pulmonary disease (COPD) and negatively affect their exercise capacity. We aimed to highlight the combined effect of Russian current and a threshold positive expiratory pressure (PEP) device on expiratory muscle strength, dyspnoea, and functional capacity in patients with COPD.
Methods:
A total of 60 males with COPD were involved in this controlled randomised trial (age ranged 55–65 years and median body mass index [BMI] was 28.68–25.96) and randomly assigned into two equal groups (30 for each), to receive combined Russian current and PEP device (study group) or PEP device only (control group), for three sessions per week over a ten-week period. Maximum expiratory pressure (MEP), dyspnoea (modified Borg scale – MBS), and functional capacity (6-minute walk test) were assessed before and after the intervention.
Results:
There was statistically significant improvement in all measured variables (MEP, MBS, and 6-minute walk test) in either the study group or the control group according to Wilcoxon’s sign rank test (all were p < 0.001 and p < 0.01, respectively), however, the study group showed a more significant improvement compared to the control group according to the Mann–Whitney U-test (p < 0.001).
Conclusions:
Combined Russian current and PEP device had a superior beneficial effect on improving dyspnoea and functional capacity by boosting the expiratory muscle strength in COPD patients, which could be implemented in their management, although further studies are needed to evaluate its maintenance effect.
REFERENCES (40)
1.
Ismail A. Online exercise rehabilitation to stable COPD patients during the second COVID wave: are physiotherapists able to help? Adv Rehabil. 2020;34(4):48–49; doi: 10.5114/areh.2020.101592.
2.
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021;396(10267):2006–2017; doi: 10.1016/S0140-6736(20)32340-0.
3.
Saey D, Michaud A, Couillard A, Côté CH, Mador MJ, LeBlanc P, et al. Contractile fatigue, muscle morphometry, and blood lactate in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;171(10):1109–1115; doi: 10.1164/rccm.200408-1005OC.
4.
Waszczykowska K, Węgierska M, Drygała R, Pawliczak R. Asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome and the risk of severe COVID-19. Pol J Allergol. 2021;8(1):21–30; doi:10.5114/pja.2021.104655.
5.
Wang K, Zeng G-Q, Li R, Luo Y-W, Wang M, Hu Y-H, et al. Cycle ergometer and inspiratory muscle training offer modest benefit compared with cycle ergometer alone: a comprehensive assessment in stable COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2655–2668; doi: 10.2147/COPD.S140093.
6.
Ninane V, Rypens F, Yernault JC, De Troyer A. Abdominal muscle use during breathing in patients with chronic airflow obstruction. Am Rev Respir Dis. 1992;146(1):16–21; doi: 10.1164/ajrccm/146.1.16.
7.
Gea J, Agustí A, Roca J. Pathophysiology of muscle dysfunction in COPD. J Appl Physiol. 2013;114(9):1222–1234; doi: 10.1152/japplphysiol.00981.2012.
8.
Weiner P, Magadle R, Beckerman M, Weiner M, Berar-Yanay N. Specific expiratory muscle training in COPD. Chest. 2003;124(2):468–473; doi: 10.1378/chest.124.2.468.
9.
Mota S, Güell R, Barreiro E, Solanes I, Ramírez-Sarmiento A, Orozco-Levi M et al. Clinical outcomes of expiratory muscle training in severe COPD patients. Respir Med. 2007;101(3):516–524; doi: 10.1016/j.rmed.2006.06.024.
10.
Schaper-Magalhães F, Pinho JF, Capuruço CAB, Rodrigues-Machado MG. Positive end-expiratory pressure attenuates hemodynamic effects induced by an overload of inspiratory muscles in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2017;12:2943–2954; doi: 10.2147/COPD.S138737.
11.
Kim N-S, Seo J-H, Ko M-H, Park S-H, Kang S-W, Won YH. Respiratory muscle strength in patients with chronic obstructive pulmonary disease. Ann Rehabil Med. 2017;41(4):659–666; doi: 10.5535/arm.2017.41.4.659.
12.
Alghamdi SM, Barker RE, Alsulayyim ASS, Alasmari AM, Banya WAS, Polkey MI et al. Use of oscillatory positive expiratory pressure (OPEP) devices to augment sputum clearance in COPD: a systematic review and meta-analysis. Thorax. 2020;75(10):855–863; doi: 10.1136/thoraxjnl-2019-214360.
13.
Clini E. Positive expiratory pressure techniques in respiratory patients: old evidence and new insights. Breathe. 2009;6(2):153–159; doi: 10.1183/18106838.0602.153.
14.
Weiner P, Magadle R, Beckerman M, Weiner M, Berar-Yanay N. Comparison of specific expiratory, inspiratory, and combined muscle training programs in COPD. Chest. 2003;124(4):1357–1364; doi: 10.1378/chest.124.4.1357.
15.
Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011;39(1):154–163; doi: 10.1177/0363546510379967.
16.
Vaz MA, Frasson VB. Low-frequency pulsed current versus kilohertz-frequency alternating current: a scoping literature review. Arch Phys Med Rehabil. 2018;99(4):792–805; doi: 10.1016/j.apmr.2017.12.001.
17.
Neder JA, Sword D, Ward SA, Mackay E, Cochrane LM, Clark CJ. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax. 2002;57(4):333–337; doi: 10.1136/thorax.57.4.333.
18.
Sillen MJH, Speksnijder CM, Eterman R-MA, Janssen PP, Wagers SS, Wouters EFM, et al. Effects of neuromuscular electrical stimulation of muscles of ambulation in patients with chronic heart failure or COPD: a systematic review of the English-language literature. Chest. 2009;136(1):44–61; doi: 10.1378/chest.08-2481.
19.
Maffiuletti NA, Minetto MA, Farina D, Bottinelli R. Electrical stimulation for neuromuscular testing and training: state-of-the art and unresolved issues. Eur J Appl Physiol. 2011;111(10):2391–2397; doi: 10.1007/s00421-011-2133-7.
20.
Wu X, Hu X, Hu W, Xiang G, Li S. Effects of neuromuscular electrical stimulation on exercise capacity and quality of life in COPD patients: a systematic review and meta-analysis. Biosci Rep. 2020;40(5):BSR20191912; doi: 10.1042/BSR20191912.
21.
Alves IGN, da Silva ESCM, Martinez BP, de Queiroz RS, Gomes-Neto M. Effects of neuromuscular electrical stimulation on exercise capacity, muscle strength and quality of life in COPD patients: a systematic review with meta-analysis. Clin Rehabil. 2022;36(4):449–471; doi: 10.1177/02692155211067983.
22.
Merkow RP, Kaji AH, Itani KMF. The CONSORT Framework. JAMA Surg. 2021;156(9):877-878. doi: 10.1001/jamasurg.2021.0549.
23.
Acqua AM, Döhnert M, Santos L. Neuromuscular electrical stimulation with Russian current for expiratory muscle training in patients with chronic obstructive pulmonary disease. J Phys Ther Sci. 2012;24(10):955–959; doi: 10.1589/jpts.24.955.
24.
American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518–624; doi: 10.1164/rccm.166.4.518.
25.
Caruso P, de Albuquerque ALP, Santana PV, Cardenas LZ, Ferreira JG, Prina E, et al. Diagnostic methods to assess inspiratory and expiratory muscle strength. J Bras Pneumol. 2015;41(2):110–123; doi: 10.1590/S1806-37132015000004474.
26.
Bausewein C, Schunk M, Schumacher P, Dittmer J, Bolzani A, Booth S. Breathlessness services as a new model of support for patients with respiratory disease. Chron Respir Dis. 2018;15(1):48–59; doi: 10.1177/1479972317721557.
27.
Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44(6):1428–1446; doi: 10.1183/09031936.00150314.
28.
Jones S, Man WD-C, Gao W, Higginson IJ, Wilcock A, Maddocks M. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database Syst Rev. 2016;10(10):CD009419; doi: 10.1002/14651858.CD009419.
29.
Sillen MJH, Franssen FME, Delbressine JML, Vaes AW, Wouters EFM, Spruit MA. Efficacy of lower-limb muscle training modalities in severely dyspnoeic individuals with COPD and quadriceps muscle weakness: results from the DICES trial. Thorax. 2014;69(6):525–531; doi: 10.1136/thoraxjnl-2013-204388.
30.
Morris MJ, Madgwick RG, Lane DJ. Difference between functional residual capacity and elastic equilibrium volume in patients with chronic obstructive pulmonary disease. Thorax. 1996;51(4):415–419; doi: 10.1136/thx.51.4.415.
31.
Chaplin EJL, Houchen L, Greening NJ, Harvey-Dunstan T, Morgan MD, Steiner MC et al. Neuromuscular stimulation of quadriceps in patients hospitalised during an exacerbation of COPD: a comparison of low (35 Hz) and high (50 Hz) frequencies. Physiother Res Int. 2013;18(3):148–156; doi: 10.1002/pri.1541.
32.
Coquart JB, Grosbois J-M, Olivier C, Bart F, Castres I, Wallaert B. Home-based neuromuscular electrical stimulation improves exercise tolerance and health-related quality of life in patients with COPD. Int J Chron Obstruct Pulmon Dis. 2016; 11:1189–1197; doi: 10.2147/COPD.S105049.
33.
Henoch I, Strang S, Löfdahl C-G, Ekberg-Jansson A. Health-related quality of life in a nationwide cohort of patients with COPD related to other characteristics. Eur Clin Respir J. 2016;3:31459; doi: 10.3402/ecrj. v3.31459.
34.
Banerjee P, Caulfield B, Crowe L, Clark A. Prolonged electrical muscle stimulation exercise improves strength and aerobic capacity in healthy sedentary adults. J Appl Physiol. 2005;99(6):2307–2311; doi: 10.1152/japplphysiol.00891.2004.
35.
Cittadin GL, Ansolin GZ, Furtado Santana NP, Tonini TL, Buzanello Azevedo MR, de Albuquerque CE et al. Comparison between Russian and Aussie currents in the grip strength and thickness muscles of the non-dominant hand: a double-blind, prospective, randomized-controlled study. Turk J Phys Med Rehabil. 2020;66(4):423–428; doi: 10.5606/tftrd.2020.4718.
36.
Bertoti DB. Electrical stimulation: a reflection on current clinical practices. Assist Technol. 2000;12(1):21–32; doi: 10.1080/10400435.2000.10132007.
37.
Suzuki S, Sato M, Okubo T. Expiratory muscle training and sensation of respiratory effort during exercise in normal subjects. Thorax. 1995;50(4):366–370; doi: 10.1136/thx.50.4.366.
38.
Shao Y-J, Chan M-L, Chen Y-H. Effects of abdominal exercise on respiratory muscles and pulmonary function in healthy males. Int J Physiother Res. 2018;6(1):2606–2612; doi: 10.16965/ ijpr.2017.262.
39.
DePalo VA, Parker AL, Al-Bilbeisi F, McCool FD. Respiratory muscle strength training with nonrespiratory maneuvers. J Appl Physiol. 2004;96(2):731–734; doi: 10.1152/japplphysiol.00511.2003.
40.
Vieira PJ, Chiappa AMG, Cipriano G Jr, Umpierre D, Arena R, Chiappa GR. Neuromuscular electrical stimulation improves clinical and physiological function in COPD patients. Respir Med. 2014;108(4):609–620; doi: 10.1016/j.rmed.2013.12.013.
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