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Master Thesis

Réhabilitation ambulatoire chez des patients ayant une BPCO : apports de l’électrostimulation des quadriceps

Abstract : Neuromuscular electrical stimulation of the quadriceps (NMES) is known to improve exercise tolerance in R severe COPD patients (pts), however, when used at home in addition to a pulmonary rehabilitation program (PR), data are few. Aim To measure the improvement when NMES is added to conventional PR Methods 52 pts with moderate to very severe COPD participated (59 + 9 y, 7 W, FEV1 24 — 59 %, 02 therapy n = 16). They were randomly assigned to receive NEMS (ES = 27) or not (NES = 25). PR took place either in an outpatients centre or at home (8 wks, 18-24 sessions). NMES was delivered by a Cefar Compex device, with an intensity set to obtain a maximal stimulation without pain, at frequency 35Hz. Pts were asked to use it 30 min per day, 5 days/wks. Dyspnoea MMRC score (D), 6 min walking distance (6MWD), maximal power during exercise test (Wmax), and St George's Hospital questionnaire for quality of life (QOL) were assessed at baseline and at the end of the program. BODE index was calculated. Results In both groups, 6MWD and Wmax were significantly improved. In the ES group, the number of achieved NMES sessions varied from 7 to 62. There was a significant improvement in D (2,3 + 0,7 vs 1,9 + 0,7, p < 0,05), BODE index (4,7 + 1,5 vs 4,2 + 1,8, p< 0,05). Increase in QOL for the total score (49 + 12 vs 44 + 14) and the symptoms score (32 + 20 vs 28 + 16) was not significant. In the NES group, increase of the scores symptoms (32 + 20 vs 27 + 17) and activities (68 ± 19 vs 63 + 21) was not significant. Conclusion Home based NEMS in addition to PR led to improvement in the BODE index through an improvement of 6MWD and dyspnoea. However, changes were moderate, and NMES sessions might have been a burden for some pts.
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Master Thesis
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Anne-Laure Roy. Réhabilitation ambulatoire chez des patients ayant une BPCO : apports de l’électrostimulation des quadriceps. Médecine humaine et pathologie. 2015. ⟨dumas-01163193⟩

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