PMID- 24399630
OWN - NLM
STAT- MEDLINE
DCOM- 20140626
LR  - 20220331
IS  - 1468-3296 (Electronic)
IS  - 0040-6376 (Linking)
VI  - 69
IP  - 6
DP  - 2014 Jun
TI  - Efficacy of lower-limb muscle training modalities in severely dyspnoeic 
      individuals with COPD and quadriceps muscle weakness: results from the DICES 
      trial.
PG  - 525-31
LID - 10.1136/thoraxjnl-2013-204388 [doi]
AB  - RATIONALE: Strength training and neuromuscular electrical stimulation (NMES) 
      improve lower-limb muscle function in dyspnoeic individuals with chronic 
      obstructive pulmonary disease (COPD). However, high-frequency NMES (HF-NMES) and 
      strength training have never been compared head-to-head; and effects of 
      low-frequency NMES (LF-NMES) have never been studied in COPD. Therefore, the 
      optimal training modality to improve lower-limb muscle function, exercise 
      performance and other patient-related outcomes in individuals with severe COPD 
      remains unknown. OBJECTIVES: To study prospectively the efficacy of HF-NMES 
      (75 Hz), LF-NMES (15 Hz) or strength training in severely dyspnoeic individuals 
      with COPD with quadriceps muscle weakness at baseline. METHODS: 120 individuals 
      with COPD (FEV1: 33+/-1% predicted, men: 52%, age: 64.8+/-0.8 years) were randomised 
      to HF-NMES, LF-NMES or strength training as part of a comprehensive inpatient 
      pulmonary rehabilitation programme. No treadmill walking or stationary cycling 
      was provided. MEASUREMENTS AND MAIN RESULTS: Groups were comparable at baseline. 
      Quadriceps muscle strength increased after HF-NMES (+10.8 Newton-metre (Nm)) or 
      strength training (+6.1 Nm; both p<0.01), but not after LF-NMES (+1.4 Nm; 
      p=0.43). Quadriceps muscle endurance, exercise performance, lower-limb fat-free 
      mass, exercise-induced symptoms of dyspnoea and fatigue improved significantly 
      compared with baseline after HF-NMES, LF-NMES or strength training. The increase 
      in quadriceps muscle strength and muscle endurance was greater after HF-NMES than 
      after LF-NMES. CONCLUSIONS: HF-NMES is equally effective as strength training in 
      severely dyspnoeic individuals with COPD and muscle weakness in strengthening the 
      quadriceps muscles and thus may be a good alternative in this particular group of 
      patients. HF-NMES, LF-NMES and strength training were effective in improving 
      exercise performance in severely dyspnoeic individuals with COPD and quadriceps 
      weakness. TRIAL REGISTRATION: NTR2322.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Sillen, Maurice J H
AU  - Sillen MJ
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands.
FAU - Franssen, Frits M E
AU  - Franssen FM
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands.
FAU - Delbressine, Jeannet M L
AU  - Delbressine JM
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands.
FAU - Vaes, Anouk W
AU  - Vaes AW
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands.
FAU - Wouters, Emiel F M
AU  - Wouters EF
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands Department of Respiratory Medicine, Maastricht 
      University Medical Centre (MUMC+), Maastricht, The Netherlands.
FAU - Spruit, Martijn A
AU  - Spruit MA
AD  - Department of Research & Education, CIRO+, Centre of Expertise for Chronic Organ 
      Failure, Horn, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140107
PL  - England
TA  - Thorax
JT  - Thorax
JID - 0417353
SB  - IM
CIN - Thorax. 2014 Oct;69(10):953. PMID: 24813193
CIN - Thorax. 2014 Oct;69(10):953-4. PMID: 24928811
MH  - Activities of Daily Living
MH  - Aged
MH  - Body Composition
MH  - Dyspnea/physiopathology/*rehabilitation
MH  - Electric Stimulation Therapy/*methods
MH  - Exercise/physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Muscle Strength/physiology
MH  - Muscle Weakness/physiopathology/*rehabilitation
MH  - Prospective Studies
MH  - Pulmonary Disease, Chronic Obstructive/physiopathology/*rehabilitation
MH  - *Quadriceps Muscle
MH  - Resistance Training/*methods
MH  - Single-Blind Method
OTO - NOTNLM
OT  - COPD Pathology
OT  - Exercise
OT  - Pulmonary Rehabilitation
EDAT- 2014/01/09 06:00
MHDA- 2014/06/27 06:00
CRDT- 2014/01/09 06:00
PHST- 2014/01/09 06:00 [entrez]
PHST- 2014/01/09 06:00 [pubmed]
PHST- 2014/06/27 06:00 [medline]
AID - thoraxjnl-2013-204388 [pii]
AID - 10.1136/thoraxjnl-2013-204388 [doi]
PST - ppublish
SO  - Thorax. 2014 Jun;69(6):525-31. doi: 10.1136/thoraxjnl-2013-204388. Epub 2014 Jan 
      7.