The effect of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease: randomised controlled trial

• Published in: Journal of clinical nursing Vol. 26; no. 13-14; pp. 1834 - 1844
• Main Authors: Öncü, Emine, Zincir, Handan
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-07-2017
• Subjects: acute exacerbation; Aged; Chronic obstructive pulmonary disease; Clinical trials; Drug therapy; Dyspnea; Evidence-based nursing; Exercise; Female; Forced Expiratory Volume; Humans; Male; Nursing; Patient Satisfaction; Physical fitness; Pulmonary Disease, Chronic Obstructive - nursing; Pulmonary Disease, Chronic Obstructive - psychology; Pulmonary Disease, Chronic Obstructive - therapy; pulmonary functions; Quality of Life; randomised controlled trial; Single-Blind Method; Surveys and Questionnaires; Transcutaneous Electric Nerve Stimulation; transcutaneous electrical nerve stimulation; Transcutaneous electrical nerve stimulation-TENS; Treatment Outcome; Turkey; acute exacerbation; randomised controlled trial; pulmonary functions; transcutaneous electrical nerve stimulation
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.13450

Aims and objectives
The aim of the present study was to assess the efficacy of transcutaneous electrical nerve stimulation in patients with acute exacerbation of chronic obstructive pulmonary disease.
Background
In patients with stable chronic obstructive pulmonary disease, transcutaneous electrical nerve stimulation has been known to attain improvement in forced expiratory volume in 1 seconds, physical activity, and quality of life. However, information about the effects of transcutaneous electrical nerve stimulation on acute exacerbation of chronic obstructive pulmonary disease is quite limited.
Design
A single‐blind, randomised controlled trial.
Methods
Data were collected between August 2013–May 2014. Eighty‐two patients who were hospitalised with a diagnosis of acute exacerbation of chronic obstructive pulmonary disease were randomly assigned to a transcutaneous electrical nerve stimulation group receiving transcutaneous electrical nerve stimulation treatment for 20 seance over the acupuncture points with pharmacotherapy or placebo group receiving the same treatment without electrical current output from the transcutaneous electrical nerve stimulation device. Pulmonary functional test, six‐minute walking distance, dyspnoea and fatigue scale, and St. George's Respiratory Questionnaire scores were assessed pre‐ and postprogram. The program started at the hospital by the researcher was sustained in the patient's home by the caregiver.
Results
All patients were able to complete the program, despite the exacerbation. The 20 seance transcutaneous electrical nerve stimulation program provided clinically significant improvement in forced expiratory volume in 1 seconds 21 ml, 19·51% but when compared with the placebo group, the difference was insignificant (p > 0·05). The six‐minute walking distance increased by 48·10 m more in the placebo group (p < 0·05). There were no significant differences between the two groups' St. George's Respiratory Questionnaire, dyspnoea and fatigue score (p > 0·05).
Conclusion
Adding transcutaneous electrical nerve stimulation therapy to pharmacotherapy in patients with acute exacerbation of chronic obstructive pulmonary disease provided clinical improvement in forced expiratory volume in 1 seconds and add benefit in exercise capacity, but no significant effect on the other outcomes measured.
Relevance to clinical practice
Transcutaneous electrical nerve stimulation can be used as a non‐invasive complementary therapy due to its beneficial effects on forced expiratory volume in 1 seconds and exercise capacity in patients with acute exacerbation of chronic obstructive pulmonary disease.