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Neuromuscular Electrical Stimulation Compared to Volitional Exercise for Improving Muscle Function in Rheumatoid
Sara R Piva1, Samannaaz S Khoja1, Frederico G S Toledo1
1University of Pittsburgh, Pittsburgh, Pennsylvania.
Arthritis Care & Research
|May 22, 2018
Summary
Neuromuscular electrical stimulation (NMES) and high-intensity resistance training both effectively improve muscle function in rheumatoid arthritis (RA) patients. NMES is a viable alternative, but higher attrition rates require consideration.
Area of Science:
- Rheumatology and Rehabilitation Medicine
- Exercise Physiology
- Muscle Biology
Background:
- Rheumatoid arthritis (RA) commonly leads to muscle dysfunction, impacting physical function and quality of life.
- Effective interventions are needed to improve muscle structure and function in RA patients.
- Comparing neuromuscular electrical stimulation (NMES) with volitional resistance training offers insights into optimizing rehabilitation strategies.
Purpose of the Study:
- To compare the feasibility and effectiveness of NMES versus high-intensity volitional resistance training in RA patients.
- To assess improvements in muscle structure, muscle function, and physical function.
- To evaluate changes in myocyte characteristics and feasibility metrics.
Main Methods:
- A 16-week, 2-group, single-blind, randomized pilot study involving adult RA patients.
- Interventions included 36 sessions of NMES (n=31) or volitional training (n=28).
- Outcome measures encompassed muscle (quadriceps area, density, strength), physical function, feasibility (pain, disease activity, attrition, adherence), and myocyte characteristics.
Main Results:
- Both NMES and volitional training significantly improved muscle structure and function (P < 0.001 to 0.019).
- No significant differences were observed between groups in muscle characteristics or physical function improvements.
- Exercise interventions did not lead to serious adverse events, increased pain, or disease activity. Attrition was higher in the NMES group (29%) compared to the volitional group (7%).
Conclusions:
- Both NMES and high-intensity volitional resistance training are effective for enhancing muscle structure and function in RA patients.
- NMES presents a viable alternative for patients who may not tolerate or are contraindicated for high-intensity resistance exercise.
- Attrition rates associated with NMES warrant careful consideration in clinical application.
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