Influence of Russian Current and Expiratory Muscle Training on Expiratory Efficiency in Patients With Chronic Obstructive Pulmonary Disease
试验速览
- 阶段
- 不适用
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- Maximum expiratory pressure
研究概览
简要总结
Respiratory muscles are essential to alveolar ventilation. In COPD, these muscles work against increased mechanical loads due to airflow limitation and geometrical changes of the thorax derived from pulmonary hyperinflation. Respiratory muscle fibers show several degrees of impairment in cellular and subcellular structures which translates, from the functional point of view, to a loss of strength (capacity to generate tension) and an increased susceptibility to failure in the face of a particular load. Expiratory Muscle Training was recommended to strengthen expiratory muscles and minimize exacerbations in addition to delaying deterioration with better functional capacity. Neuromuscular electrical stimulation (NMES) is emerging as a new rehabilitation modality for muscle strengthening that does not evoke dyspnea to obtain a benefit in patients who are unable to participate in a traditional rehabilitation program
详细描述
Chronic Obstructive Pulmonary Disease (COPD) remains the fourth leading cause of chronic morbidity and mortality at the global level, and it represents a major problem for public health. It is known that expiratory muscles are usually activated at the end of expiration in COPD patients during rest, or weight-bearing breathing to compensate weakness of inspiratory muscle and lung hyperinflation by time, expiratory muscle fatigue and weakness take place and more lung deterioration affecting COPD patient functional capacity occur.
The efficacy of pulmonary rehabilitation on chronic obstructive pulmonary disease (COPD) patients has been demonstrated in many studies. Although pulmonary rehabilitation is a multi-dimensional therapy, respiratory muscle training and strengthening appears to be its most effective component, expiratory muscle training improves functional exercise capacity as assessed by timed walking distance, and decreases dyspnea during daily living activities, resulting in a better health-related quality of life in patients with COPD. Russian current is a medium frequency current, which was developed for improving muscle strength. There is limited literature on the effect of Russian current in improving strength of respiratory muscles. Thus, a need arises which addresses this perspective for new management strategies
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 55 Years 至 65 Years（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Men with stage II COPD Patients
- •aged from 55 to 65 years' old
- •FEV1/FVC less than 70% (Patients of moderate COPD (Stage II- GOLD criteria) (Rabe et al, 2019)
- •BMI 25.0-29.9 kg/m2 (Pre-obesity)
- •Tobacco smokers
- •No history of infections or symptom exacerbations in the previous two months before the study
- •Did not participate in any selective exercise program for the respiratory muscles before
排除标准
- •Acute exacerbation that requires a change in pharmacological management or hospitalization
- •An open injury affecting the application of surface electrodes of russian current
- •Asthmatic patient.
- •Implanted pacemaker
- •Patients with chest infection.
- •Patients with pleural diseases.
- •Primary valvular disease
- •History of spontaneous pneumothorax
- •Clinically significant peripheral vascular disease
- •Severe anemia
- •BMI more than 29.9 kg/m2
- •Previous lung surgery
- •Long-term oxygen treatment
- •Patients with chronic renal failure.
- •Any cognitive impairment that interferes with prescribed exercise procedures
- •Musculoskeletal or neurological limitation to physical exercise
- •Any patient enrolled in an anther research study for at least 30 days
结局指标
主要结局
Maximum expiratory pressure
时间窗: 10 weeks
It is used to measure MEP with a pressure manometer. Measurements are usually made with patients in a sitting position and with a nose clip, Patients perform a maximal expiratory effort and sustain it for 1 to 2 seconds. The maneuver should be repeated 3 to 8 times, and the highest value recorded is used for analysis. The value obtained from the best of at least three efforts, measured at 2-min intervals, was used. Measurements will be obtained from TLC which yield higher values than those obtained of measurements from FRC
次要结局
- dyspnea assessment(10 weeks)
- functional capacity(10 weeks)
- COPD Assessment Test(10 weeks)
- forced vital capacity(10 weeks)
- Forced expiratory volume in the first second(10 weeks)
- maximal voluntary ventilation(10 weeks)
研究者
Hassan Mohamed Hassan
researcher
Cairo University