Skeletal muscle effects of electrostimulation after COPD exacerbation: a pilot study
Skeletal muscle effects of electrostimulation after COPD exacerbation: a pilot study
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DOI：
10.1183/09031936.00167110
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发表时间：
2011-10-01
影响因子：
24.3
通讯作者：
Hayot, M.
中科院分区：
文献类型：
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作者：
Abdellaoui, A.;Prefaut, C.;Hayot, M.
肌肉功能障碍是慢性阻塞性肺疾病（COPD）的主要问题，特别是在加重后。因此，我们询问神经肌肉电刺激（NMES）是否可能在急性加重后直接有用，以及这种治疗是否会降低肌肉氧化应激和/或改变肌纤维分布。在COPD急性加重后的15名住院患者（n=9 NMES; n=6假手术）中进行了为期6周的NMES初步随机对照研究。刺激被传递到股四头肌和腿筋肌肉（35 Hz）。研究结束时，两组之间的股四头肌力量改善具有统计学差异（p=0.02），仅NMES组显著增加（中位数（四分位距）10（4.7-11.5）kg; p=0.01）。两组之间6分钟步行距离的变化存在统计学差异（p=0.008），NMES组显著增加（165（125-203）m; p=0.003）。NMES不会导致更高的肌肉氧化应激，如总蛋白羰基化（p=0.02）和肌球蛋白重链羰基化（p=0.01）水平降低所示。最后，我们观察到NMES组I型纤维比例显著增加。我们的研究表明，在COPD急性加重后，NMES可有效对抗肌肉功能障碍并降低肌肉氧化应激。
Muscle dysfunction is a major problem in chronic obstructive pulmonary disease (COPD), particularly after exacerbations. We thus asked whether neuromuscular electrostimulation (NMES) might be directly useful following an acute exacerbation and if such a therapy decreases muscular oxidative stress and/or alters muscle fibre distribution.A pilot randomised controlled study of NMES lasting 6 weeks was carried out in 15 in-patients (n=9 NMES; n=6 sham) following a COPD exacerbation. Stimulation was delivered to the quadriceps and hamstring muscles (35 Hz). Primary outcomes were quadriceps force and muscle oxidative stress.At the end of the study, quadriceps force improvement was statistically different between groups (p=0.02), with a significant increase only in the NMES group (median (interquartile range) 10 (4.7-11.5) kg; p=0.01). Changes in the 6-min walking distance were statistically different between groups (p=0.008), with a significant increase in the NMES group (165 (125-203) m; p=0.003). NMES did not lead to higher muscle oxidative stress, as indicated by the decrease in total protein carbonylation (p=0.02) and myosin heavy chain carbonylation (p=0.01) levels. Finally, we observed a significant increase in type I fibre proportion in the NMES group.Our study shows that following COPD exacerbation, NMES is effective in counteracting muscle dysfunction and decreases muscle oxidative stress.