holcroft lb 1, coughlan gf 1, caulfield b 1, crowe l 1, barry p 2, nicholson t 2, gallagher cg 2 1...

Holcroft LB1, Coughlan GF1, Caulfield B1, Crowe L1,Barry P2, Nicholson T2, Gallagher CG2

1 Stim XDP Research Group, Institute for Sport and Health, University College Dublin, Ireland.2St. Vincent’s University Hospital , Elm Park ,Dublin 4, Ireland.

lorna.holcroft@ucdconnect.ie Keywords: Neuromuscular electrical stimulation, physical fitness, cystic fibrosis

INTRODUCTIONCystic Fibrosis (CF) is the most common life-limiting genetic

disease in caucasians.1 Skeletal muscle weakness and

exercise intolerance is prevalent in people with cystic fibrosis.2

Although higher levels of fitness have been associated with

better quality of well-being and improved eight year survival

training among individuals with CF is limited due to fatigue,

hypoxaemia and dyspnoea.3 Neuromuscular electrical

stimulation (NMES) has demonstrated improvements in

muscle strength, exercise tolerance and aerobic capacity in

cardiorespiratory disease populations, while having minimal

impact on oxygen saturation levels and heart rate.4,5

METHODS11 participants (9 males, 2 females) undertook a 6 week

NMES training program. Training consisted of NMES to the major leg muscles (Figure 1) for 1 hour /day, 5 days a

week for 6 weeks. The effects of the intervention were

measured by means of pulmonary function testing (PFT), a Modified

Shuttle Walk Test (MST) and isokinetic measurement of quadriceps (Q) and hamstring (H) strength. Descriptive statistics were used to analyse the results.

RESULTS6 participants (5 males and 1 female) completed the study

(Age: 28.83 ± 5.12 years, BMI: 21.68 ± 2.49 kg/m2).

5 participants withdrew (4 due to pulmonary exacerbations

and 1 due to personal reasons). Results are presented in

Table 1.

CONCLUSIONNMES does appear to have potential as a means of

physical training for people with CF for whom participation in

traditional exercise programs is not feasible .

REFERENCES1. CF Foundation National Patient Registry Annual Data Report. Bethesda,

Maryland 2002.2. Troosters T et al. Skeletal muscle weakness, exercise tolerance and physical Inactivity in adults with CF. Eur Respir J 2009;33 99-1063. Nixon et al. The prognostic value of exercise testing in patients with CF. N Eng

JMedicine. 1992. 327: 1785-17884. Vivodtzev I et al. NMES of the Lower Limbs in Patients with COPD. JCRP 2008

28:79-915. Banerjee P et al. EMS Exercise Improves Strength, Peak VO2 and Exercise

CapacityIn Patients with Stable CHF.J Cardiac Fail 2009; 1-9

ACKNOWLEDGEMENTS

With grateful appreciation to all study participants and collaborators:

Dr. Garrett Coughlan, Dr. Brian Caulfield, Dr. Louis Crowe, Dr. Peter Barry,

Dr. Trevor Nicholson .

ACPRC Annual Conference, Nottingham, UK, 16th - 17th April, 2010

A pilot investigation into the effects of neuromuscular electrical stimulation training on physical fitness in an adult cystic fibrosis population.

Fig 1. NMES Applied to the hamstrings and quadriceps muscles.

Results Summary:

4% increase in Q peak torque

16% increase in H peak torque

5% increase in MST

No change in FEV1%

Table 1: Mean ResultsM – metres, Nm iso – Newton metres isokinetic