An Experience of Limbs Electrical Stimulation for a Patient with Very Severe COPD

一位極嚴重程度慢性阻塞性肺疾病病人使用肌肉電刺激之肺部復健經驗

Chia-Meng Lin ； Horng-Chyuan Lin ； Wen-Chin Jao

《呼吸治療》 11卷2期 (2012/07) Pp. 54-54

https://doi.org/10.6269/JRT.2012.11.2.06

並列摘要

”Purpose:” Electrical muscle stimulation (EMS) would be considered to be a new strategy of pulmonary rehabilitation for COPD patients, which do not need patients cooperation. EMS has been widely used as a rehabilitation to improve muscle structure and function in different disease. Chronic obstructive pulmonary disease (COPD) would lead to peripheral muscle atrophy and weakness. Electrical muscle stimulation may be an alternative to active exercise in COPD patients. The aim of our study was to investigate the EMS effects on hospitalized patients with severe to very severe COPD.”Clinical assess:” Mr. De was 87 years old man. He was suffered from SOB, no fever and productive cough with yellow sputum for several days on 2011/05/05. He came for help and diagnosis: AECOPD. CXR: bilateral pneumonia patches. We decided intubation immediately. He accepted a completed treatment in ICU and weaning on 2011/05/11. 2011/05/12 was transferred to ward and 3L/min nasal cannula used. He till suffered from dyspnea when walking and resting. He need his family did anything for him. He and his family did not well understand about COPD and did not encourage for activities and exercise. SpO2 was detected; the data was 84% without oxygen supplement. SGRQ score was 61.28. So we arranged EMS training for him in ward on 2011/05/13.”Respiratory issues:” 1. Disease acknowledge was lacking cause anxiety. Hypoxia cause exercise intolerated.”Respiratory care”: 1. Education about disease progression and daily care. 2. Breathing control training. 3. EMS 4. Psychological support. He was received a 2-week EMS on quadriceps femoris and triceps brachii muscle. EMS was applied daily using biphasic, symmetric impulses (50 Hz, 200 microseconds pulse duration, 6 seconds on and 50 seconds off at intensities as tolerated) for 30 min, twice a day.”Results:” He was completed the training. Pulmonary function [forced vital capacity (FVC), FEV1 and PEF] improved significantly (0.8-1.65, 0.44-0.93 and 1.23-2.51, respectively) and increased the 6-min walking distance from 143 to 272 meters. EMS also significantly improved the SGRQ activity, impact and total score (66.95-35.79, 62.20-26.32 and 61.28-32.59). (The form abridges)”Conclusions:” EMS is well tolerated and provides a rehabilitation tool to improve limb muscle performance, exercise capacity and pulmonary function in hospitalized patients with advanced COPD.