Lei Pan and YongZhong Guo contributed equally to this work.
Lack of efficacy of neuromuscular electrical stimulation of the lower limbs in chronic obstructive pulmonary disease patients: A meta-analysis
Article first published online: 21 NOV 2013
© 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology
Volume 19, Issue 1, pages 22–29, January 2014
How to Cite
Pan, L., Guo, Y., Liu, X. and Yan, J. (2014), Lack of efficacy of neuromuscular electrical stimulation of the lower limbs in chronic obstructive pulmonary disease patients: A meta-analysis. Respirology, 19: 22–29. doi: 10.1111/resp.12200
(Associate Editor: Bob Hancox).
- Issue published online: 23 DEC 2013
- Article first published online: 21 NOV 2013
- Manuscript Revised: 27 AUG 2013
- Manuscript Accepted: 27 AUG 2013
- Manuscript Revised: 14 AUG 2013
- Manuscript Revised: 28 JUL 2013
- Manuscript Revised: 28 MAY 2013
- Manuscript Received: 6 MAR 2013
- chronic obstructive pulmonary disease;
- electrical stimulation;
Randomized controlled trials (RCT) were carried out to investigate the role of neuromuscular electrical stimulation (NMES) in patients with chronic obstructive pulmonary disease (COPD). However, these studies have small sample size and different measures for evaluating outcomes, and convey inconclusive results. We carried out a meta-analysis to assess the effects of NMES to COPD patients.
A computerized search was performed through PubMed and Embase databases (up to December 2012) for relevant RCT. Two investigators independently screened the articles. The primary outcome measures were quadriceps strength and exercise capacity, secondary outcomes included dyspnoea and muscle fibre characteristics. The weighted mean difference (WMD) or standardized mean difference and the 95% confidence interval (CI) were calculated, and the heterogeneity was assessed with the I2 test.
Eight trials involving 156 patients were included in this meta-analysis. We found that NMES was not associated with significant changes in quadriceps strength (standardized mean difference 0.38; 95% CI: −0.13–0.89) nor 6 min walk distance (WMD 13.63 m; 95% CI: −17.39–44.65). NMES failed to improve the muscle fibre characteristics (type I: WMD 1.09%; 95% CI: −19.45–21.64; type IIa: WMD −7.50%; 95% CI: −19.81–4.81). NMES significantly improved dyspnoea (WMD −0.98 scores; 95% CI: −1.42– −0.54).
Evidence to support the benefits of NMES to COPD patients is currently inadequate. Larger-scale studies are needed to investigate the efficacy of NMES.