Neuromuscular Electrical Stimulation And Transcutaneous Electrical Diaphragmatic Stimulation In Hospitalized Patients With Chronic Cardiorespiratory Diseases: A Randomized Clinical Trial

  • Aline de Cássia Meine Azambuja Universidade Luterana do Brasil
  • Andressa de Almeida Kuhn Universidade Luterana do Brasil
  • Larissy dos Santos Américo Universidade Luterana do Brasil
  • Maria Camila da Silva Universidade Luterana do Brasil
  • Priscila Paula dos Santos Universidade Luterana do Brasil
  • Laura Jurema dos Santos Universidade Luterana do Brasil

Abstract

Objective: To evaluate and compare the effects of two modalities of respiratory and peripheral muscle training in patients with chronic cardiorespiratory diseases. Methodology: A randomized clinical trial performed from September 2015 to December 2016 at the University Hospital of Canoas/RS, Brazil. Patients were randomized into 2 groups: Group I (Intervention) - transcutaneous electrical diaphragmatic stimulation (TEDS) and neuromuscular electrical stimulation (NMES) associated with voluntary contraction; and Group II (Conventional) - peripheral muscle training through mechanical resources and respiratory training through Power Breathe®. Both groups performed a respiratory and motor physiotherapy protocol standardized by the research team. The evaluation consisted of assessing respiratory muscle strength through MIP and MEP, peripheral muscle strength through the Medical Research Council (MRC) score and functionality through the Functional Independence Measure (FIM) scale. The level of significance was set at p≤0.05 and the analyses were performed in the SPSS program version 21.0. Results: Twenty patients were included in the study, 11 belonging to Group I and 9 to Group II. The mean age was 68.7 ± 12.1 years, with a prevalence of the female gender (65%). The intervention group had a significant increase in MEP (p = 0.011), functional independence (p = 0.024), left palmar grip strength (p = 0.017) and peripheral muscle strength (p = 0.012). Conclusion: Both training modalities improved expiratory and peripheral muscle strength. In addition, there was only an increase in functional independence in the intervention group (NMES + TEDS).

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Author Biographies

Aline de Cássia Meine Azambuja, Universidade Luterana do Brasil
Fisioterapeuta - R2 - Residência Multiprofissional em saúde do adulto e idoso do Hospital Universitário de Canoas/RS
Andressa de Almeida Kuhn, Universidade Luterana do Brasil
Fisioterapeuta - R1 - Residência Multiprofissional em saúde do adulto e idoso do Hospital Universitário de Canoas/RS
Larissy dos Santos Américo, Universidade Luterana do Brasil
Fisioterapeuta - R1 - Residência Multiprofissional em saúde do adulto e idoso do Hospital Universitário de Canoas/RS
Maria Camila da Silva, Universidade Luterana do Brasil
Fisioterapeuta - R1 - Residência Multiprofissional em saúde do adulto e idoso do Hospital Universitário de Canoas/RS
Priscila Paula dos Santos, Universidade Luterana do Brasil
Fisioterapeuta - R1 - Residência Multiprofissional em saúde do adulto e idoso do Hospital Universitário de Canoas/RS
Laura Jurema dos Santos, Universidade Luterana do Brasil
Docente do Curso de Fisioterapia da Universidade Luterana do Brasil - ULBRA

References

Dana P, Penciu OM, Sitar-Taut AV, et al. Comparative heart failure profile over a 3-year period in a Romanian general hospital Clinical Interventions in Aging. 2013; 8(1): 999-1005.

Barnes PJ, Celli BR. Systemic manifestations and comorbidities of COPD. Eur Respir J. 2009; 33(5): 1165-1185.

Atualização da Diretriz Brasileira de Insuficiência Cardíaca Crônica. Sociedade brasileira de cardiologia. Arq Bras Cardiol. 2012; 98(1): 1-33.

Plentz RDM, Sbruzzi G, Ribeiro RA, Ferreira JB, Dal Lago P. Treinamento Muscular Inspiratório em Pacientes com Insuficiência Cardíaca: Metanálise de Estudos Randomizados. Arq Bras Cardiol. 2012; 99(2): 762-771.

Araújo TL, Resqueti VR, Bruno S, Azevedo IG, Dourado Jr ME, Fregonezi G. Respiratory muscle strength and quality of life in myotonic dystrophy patients. Rev Port Pneumol. 2010; 16(6): 892-898.

Smart NA, Dieberg G, Giallauria F. Functional electrical stimulation for chronic heart failure: A meta-analysis. 2013; 167(1): 80-86.

Nohama P, Jorge RF, Valenga MH. Efeitos da estimulação diafragmática transcutânea sincronizada em pacientes com doença pulmonar obstrutiva crônica (DPOC): um estudo piloto. Ver Bras Eng Biom. 2012; 28(2): 103-115.

Costa D, Forti EMP, Moulim BMC, et al. Estudo dos volumes pulmonares e da mobilidade toracoabdominal de portadoras de obesidade mórbida, submetidas à cirurgia bariátrica, tratadas com duas diferentes técnicas de fisioterapia. Ver Bras Fisioter. 2009; 13(4): 294-301.

Vivodtzev I, Debigaré R, Gagnon P, Mainguy V, Saey D, Dubé A, et al. Functional and muscular effects of neuromuscular electrical stimulation in patients with severe COPD: a randomized clinical trial. Chest. 2012; 141(3): 716–25.

Padula CA, Yeaw E, Mistry S. A home-based nurse-coached inspiratory muscle training intervention in heart failure. Appl Nurs Res. 2009; 22(1): 18-25.

Bosnak-Guclu M, Arikan H, Savci S, Inal-Ince D, Tulumen E, Aytemir K, et al. Effects of inspiratory muscle training in patients with heart failure. Respir Med. 2011; 105(11): 1671-81.

Craft-Nordon A, Schenkman M, Edbrooke L, Malone DJ, Moss M, Denehy L. The Physical Function Intensive Care Test: Implementation in Survivors of Critical Illness. Phys Ther. 2014; 94(10): 1499-1507.

Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999; 32(6): 719-27.

Dantas CM, Silva PFS, Siqueira FHT, Pinto RMF, Matias S, Maciel C. et al. Influência da mobilização precoce na força muscular periférica e respiratória em pacientes críticos. Rev Bras Ter Intensiva. 2012; 24(2): 173-178.

Ikel D, Jamami M, Marino D. et al. Effects of the resistance exercise in upper limbo n peripheral muscular strength and functionality of COPD patient. Fisioter Mov. 2010; 23 (3): 429- 437.

Hodgson, C. et al. Clinical review: Early patient mobilization in the ICU. Critical Care. 2013; 17(207): 1-2.

Charususin N, Gosselink R, Decramer M. et al. Inspiratory muscle training protocol for patients with chronic obstructive pulmonary disease (IMTCO study): a multicentre randomized controlled trial. BMJ Ope. 2015; 3(3101): 136.

Cancelliero-Gaiad KM, Ike D, Pantoni CB. et al. Acute effects of transcutaneous electrical diaphragmatic stimulation on respiratory pattern in COPD patients: cross-sectional and comparative clinical trial. Braz J Phys Ther. 2013; 17(6): 547-55.

Forgiarini Jr, Rubleski A, Garcia D et al. Avaliação da Força Muscular Respiratória e da Função Pulmonar em Pacientes com Insuficiência Cardíaca. Arq Bras Cardiol. 2007; 89(1): 36-41.

Huang C-H, Yang G-G, Wu Y-T, Lee C-W. Comparison of inspiratory muscle strength training effects between older subjects with and without chronic obstructive pulmonary disease. J Formos Med Assoc. 2011; 110(8): 518-26.

Borst MM, Meyer FJ, Zugck C, Kirschke A, Schellberg D, Kubler W, et al. Respiratory muscle dysfunction in congestive heart failure. Circulation. 2001;103: 2153-8.

Evans SA, Watson L, Hawkins M, Cowley AJ, Johnston IDA, Kinnear W. Respiratory muscle strength in chronic heart failure. Thorax. 1995; 50: 625-8.

Meyer FJ, Zugck C, Haass M, Otterspoor L, Strasser RH, Kübler W, et al. Inefficient ventilation and reduced respiratory muscle capacity in congestive heart failure. Basic Res Cardiol. 2002; 95: 333-42.

Emmanouilidis A, Goulart C, Bordin DF et al. Handgrip Strenght and Dyspnea on patients with Chornic Obstrutive Pulmonary Disease. Cinergis. 2016; 17 (3): 214-218.

Jones S, Man WD, Gao W, et al. Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease. Cochrane Database Syst Rev. 2016; 17;10.

Kaymaz D, Ergün P, Demirci E, et al. Comparison of the effects of neuromuscular electrical stimulation and endurance training in patients with severe chronic obstructive pulmonary disease. Tuberk Toraks. 2015;63(1):1-7.

Sbruzzi G, Ribeiro RA, Schaan BD, Signori LU, Silva AM, Irigoyen MC, et al. Functional electrical stimulation in the treatment of patients with chronic heart failure: a meta-analysis of randomized controlled trials. Eur J Cardiovasc Prev Rehabil2010 Jun;17(3):254-60.

Vogiatzis I, Zakynthinos S. The physiological basis of rehabilitation in chronic heart and lung disease. J Appl Physiol. 2013; 115(1): 16-21.

Needham DM, Truong AD, Fan E. Technology to enhance physical rehabilitation of critically ill patients. Crit Care Med. 2009 Oct;37(10Suppl):S436-41.

Nápolis LM, Corso SD, Neder JA, Malaguti C, Gimenes ACO, Nery LE. Neuromuscular electrical stimulation improves exercise tolerance in chronic obstructive pulmonary disease patients with better preserved fat-free mass. Clinics; 2011; 66(3): 401–406.

Published
26-12-2019
How to Cite
MEINE AZAMBUJA, A. DE C.; KUHN, A. DE A.; AMÉRICO, L. DOS S.; DA SILVA, M. C.; DOS SANTOS, P. P.; DOS SANTOS, L. J. Neuromuscular Electrical Stimulation And Transcutaneous Electrical Diaphragmatic Stimulation In Hospitalized Patients With Chronic Cardiorespiratory Diseases: A Randomized Clinical Trial. Journal of Respiratory and CardioVascular Physical Therapy, v. 7, n. 2, p. 3-12, 26 Dec. 2019.
Section
Artigos