PUTTING THE COPD NATIONAL ACTION PLAN INTO PRACTICE WITH ACP
The National Institute of Health (NIH) recently released the chronic obstructive pulmonary disease (COPD) National Action Plan which aims to reduce the burden of the third leading cause of death and fourth leading cause of disability in the United States. There are 16 million Americans diagnosed with COPD and many more who do not know they have the disease. It affects the ability to breathe, leads to long-term disability, significantly affects quality of life, and costs Americans $32 billion annually.¹
ACP technology and therapy pathways directly relate to goals two and four of the five goal plan. The second stated goal is to improve the diagnosis, prevention, treatment, and management of COPD by improving the quality of care delivered across the health care continuum. The fourth goal is to increase and sustain research to better understand the prevention, pathogenesis, diagnosis, treatment, and management of COPD. ACP can assist rehabilitation therapists who treat COPD patients with goals of improving strength and functional ability.
• According to research, patterned electrical nerve stimulation (PENS) applied to the quadricep and hamstring muscles of patients with COPD 3 x/week x 6 weeks results in 30% increased strength compared to patients treated with sham e-stim. Functionally, those treated with PENS increased the distance walked on a Shuttle Walk Test 34% over the placebo group.²
• Additional research shows an increase in exercise tolerance manifested by longer distances walked in patients with COPD receiving NMES, and suggests that NMES to the lower limbs may be applied as an additional form of pulmonary rehabilitation in this population. 3
Functional electrical stimulation (FES) involves using electrical stimulation to facilitate muscle contraction during functional activity. In the severely deconditioned COPD population, this type of e-stim and activity done continuously or through interval training can aid in enhancing aerobic capacity for participation in therapy.
1. COPD National Action Plan (https://www.nhlbi.nih.gov/health-pro/resources/lung/copd-national-action-plan)
2. Bourjeily-Habr G, Rochester CL, Palermo F,Synder P, Mohsenin V: Randomized controlled trial of transcutaneous electrical nerve stimulation of the lower extremities in patients with chronic obstructive pulmonary disease. Thorax 57(12): 1045-1049, 2002.
3. Kucio C, Niesporek J, Kucio E, Narloch D, Wegrzyn B: Evaluation of the Effects of Neuromuscular Electrical Stimulation of The Lower Limbs Combined with Pulmonary Rehabilitation on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease. Journal of Human Kinetics (54) 75882, 2016.
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