Pulmonary rehabilitation is one of the key elements of treatment in COPD that often gets lost in the dust. Patients with severe COPD have significant limitations that frequently keep them from getting help from this valuable technique. We know that COPD is not just a disease of the lungs, but is a systemic disease which often involves the muscles of the body. Because patients with COPD are short of breath on exertion and many times have difficulty getting out of the house to attend rehabilitation sessions three times a week, and because insurance companies often will not pay for therapy for extended periods of time, other ways to maintain muscle strength have been explored.
Methods that can be effective in maintaining muscle strength, but could be administered by the patient at home, would certainly be helpful. Recently, a study looked at a technique called neuromuscular electrical stimulation (NMES). This technique uses a battery powered device that is attached to the large muscles in the legs (quadriceps) and stimulates the contraction of theses muscles, much as would occur with exercise. This technique has been effectively used in critically ill patients and it does not require any effort on the part of the patient. Moreover, NMES has been shown to create systemic improvement as well. The effect of the treatment wore off quickly after stopping, suggesting that this therapy may need to be one used chronically in patients with moderate to severe COPD or perhaps earlier in the disease to prevent loss of muscle function.
