Acu-TENS Reduces Breathlessness during Exercise in People with Chronic Obstructive Pulmonary Disease

Shirley P C Ngai, Lissa M Spencer, Alice Y M Jones, Jennifer A Alison, Shirley P C Ngai, Lissa M Spencer, Alice Y M Jones, Jennifer A Alison

Abstract

Background. Exertional dyspnoea limits level of physical activity in people with Chronic Obstructive Pulmonary Disease (COPD). This randomized, double-blinded, crossover study evaluated the effect of Acu-TENS, application of Transcutaneous Electrical Nerve Stimulation on acupoints, on breathlessness during exercise in people with COPD. Methods. Twenty-one participants, mean% predicted FEV1 50 ± 21%, attended assessment followed by two intervention days, one week apart. On each intervention day, participants performed two endurance shuttle walk tests (ESWT) (Walk 1 and Walk 2). Walk 1 was performed without intervention and Walk 2 was performed with either Acu-TENS or Sham-TENS, in random order, for 45 minutes before and during Walk 2. Duration of each ESWT and dyspnoea score at isotime of Walk 1 and Walk 2 on each intervention day were compared. Between-group differences in ESWT duration and isotime dyspnoea were also compared. Results. At isotime of Walk 1 and Walk 2, Acu-TENS showed significant reduction in dyspnoea of -0.8 point (95% CI -0.2 to -1.4) but not in Sham-TENS [0.1 point (95% CI -0.4 to 0.6)]. Compared to Sham-TENS, Acu-TENS showed significant reduction in dyspnoea of -0.9 point (95% CI -0.2 to -1.6) while no between-group significance was found in ESWT duration. Conclusion. Acu-TENS alleviated dyspnoea during walking in people with COPD but did not increase walking duration.

Conflict of interest statement

No competing financial interests exist.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Points chosen for Acu-TENS and Sham-TENS. (a) Acu-TENS: application of TENS on acupuncture points, EX-B1 (Dingchuan). (b) Sham-TENS: application of TENS on nonacupuncture points, patella.
Figure 3
Figure 3
One participant performing the 2nd ESWT with Acu-TENS/Sham-TENS during the intervention day. Note: to ensure blinding of assessor to application position the leads for both applications protruded at the waist and all participants wore a towel around the neck and long pants for both applications.

References

    1. Lau K. S. L., Jones A. Y. M. A single session of Acu-TENS increases FEV1 and reduces dyspnoea in patients with chronic obstructive pulmonary disease: a randomised, placebo-controlled trial. Australian Journal of Physiotherapy. 2008;54(3):179–184. doi: 10.1016/s0004-9514(08)70024-2.
    1. Ngai S. P. C., Jones A. Y. M., Hui-Chan C. W. Y., Ko F. W. S., Hui D. S. C. Effect of 4 weeks of Acu-TENS on functional capacity and β-endorphin level in subjects with chronic obstructive pulmonary disease: a randomized controlled trial. Respiratory Physiology and Neurobiology. 2010;173(1):29–36. doi: 10.1016/j.resp.2010.06.005.
    1. Ngai S. P. C., Jones A. Y. M., Hui-Chan C. W. Y., Yu H. P. M., He C. Q. Acute effects of Acu-TENS on FEV 1 and blood β-endorphin level in chronic obstructive pulmonary disease. Alternative Therapies in Health and Medicine. 2011;17(5):8–13.
    1. Ngai S. P. C., Jones A. Y. M., Hui-Chan C. W. Y., Ko F. W. S., Hui D. S. C. An adjunct intervention for management of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) Journal of Alternative and Complementary Medicine. 2013;19(2):178–181. doi: 10.1089/acm.2011.0222.
    1. Vestbo J., Hurd S. S., Agustí A. G., et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease GOLD executive summary. American Journal of Respiratory and Critical Care Medicine. 2013;187(4):347–365. doi: 10.1164/rccm.201204-0596PP.
    1. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi: 10.1001/jama.2013.281053.
    1. Miller M. R., Hankinson J., Brusasco V., et al. Standardisation of spirometry. European Respiratory Journal. 2005;26(2):319–338. doi: 10.1183/09031936.05.00034805.
    1. Quanjer P. H., Tammeling G. J., Cotes J. E., Pedersen O. F., Peslin R., Yernault J. C. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European community for steel and coal. Official statement of the European Respiratory Society. The European Respiratory Journal. Supplement. 1993;16:5–40.
    1. Singh S. J., Morgan M. D. L., Scott S., Walters D., Hardman A. E. Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax. 1992;47(12):1019–1024. doi: 10.1136/thx.47.12.1019.
    1. McKeough Z. J., Leung R. W. M., Alison J. A. Shuttle walk tests as outcome measures: are two incremental shuttle walk tests and two endurance shuttle walk tests necessary? American Journal of Physical Medicine and Rehabilitation. 2011;90(1):35–39. doi: 10.1097/phm.0b013e3181fc7f42.
    1. Revill S. M., Morgan M. D. L., Singh S. J., Williams J., Hardman A. E. The endurance shuttle walk: a new field test for the assessment of endurance capacity in chronic obstructive pulmonary disease. Thorax. 1999;54(3):213–222. doi: 10.1136/thx.54.3.213.
    1. Borg G. A. V. Psychophysical bases of perceived exertion. Medicine and Science in Sports and Exercise. 1982;14(5):377–381.
    1. Ries A. L. Minimally clinically important difference for the UCSD Shortness of Breath Questionnaire, Borg Scale, and Visual Analog Scale. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2005;2(1):105–110. doi: 10.1081/copd-200050655.
    1. Wang J. Q., Mao L., Han J.-S. Comparison of the antinociceptive effects induced by electroacupuncture and transcutaneous electrical nerve stimulation in the rat. International Journal of Neuroscience. 1992;65(1-4):117–129. doi: 10.3109/00207459209003283.
    1. Sluka K. A., Deacon M., Stibal A., Strissel S., Terpstra A. Spinal blockade of opioid receptors prevents the analgesia produced by TENS in arthritic rats. Journal of Pharmacology and Experimental Therapeutics. 1999;289(2):840–846.
    1. Kalra A., Urban M. O., Sluka K. A. Blockade of opioid receptors in rostral ventral medulla prevents antihyperalgesia produced by transcutaneous electrical nerve stimulation (TENS) Journal of Pharmacology and Experimental Therapeutics. 2001;298(1):257–263.
    1. Greer J. J., Carter J. E., al-Zubaidy Z. Opioid depression of respiration in neonatal rats. The Journal of Physiology. 1995;485(3):845–855. doi: 10.1113/jphysiol.1995.sp020774.
    1. Takita K., Herlenius E. A. P., Lindahl S. G. E., Yamamoto Y. Actions of opioids on respiratory activity via activation of brainstem and κ-receptors; an in vitro study. Brain Research. 1997;778(1):233–241. doi: 10.1016/S0006-8993(97)01105-0.
    1. Tagaya E., Tamaoki J., Chiyotani A., Konno K. Stimulation of opioid mu-receptors potentiates beta adrenoceptor-mediated relaxation of canine airway smooth muscle. Journal of Pharmacology and Experimental Therapeutics. 1995;275(3):1288–1292.

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