A case of a patient with exacerbation of interstitial lung disease whose activities of daily living were improved by pulmonary rehabilitation with neuromuscular electrical stimulation
Introduction: We report a case of a patient with severe hypoxemia after exacerbation of interstitial lung disease (ILD), whose activities of daily living improved with the use of neuromuscular electrical stimulation (NMES).Case presentation: The patient, a 70-year-old male, was hospitalized for exac...
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| Published in | Journal of respiratory physical therapy Vol. 3; no. 1; pp. 69 - 74 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Respiratory Physical Therapy
22.03.2024
一般社団法人 日本呼吸理学療法学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2436-7966 |
| DOI | 10.51116/kokyurigakuryohogaku.3.1_69 |
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| Abstract | Introduction: We report a case of a patient with severe hypoxemia after exacerbation of interstitial lung disease (ILD), whose activities of daily living improved with the use of neuromuscular electrical stimulation (NMES).Case presentation: The patient, a 70-year-old male, was hospitalized for exacerbation of ILD, and physical therapy was started on the 15th day of hospitalization. Transferring was possible with light assistance, but walking was difficult. He was independent in eating and used a urinal and a bedpan for defecation. Transcutaneous arterial blood oxygen saturation decreased from 95% to 89% during sitting and standing motions while inhaling 6 L/min of oxygen. Since high-intensity exercise therapy was difficult, NMES was started on the 36th day of hospitalization, taking hypoxemia into consideration.Results: Isometric knee extension muscle strength improved by 4.3-6.2 kgf and continuous walking distance improved to 40 m. The patient became independent in activities of daily living and was discharged home.Conclusion: For patients following an exacerbation of ILD, the combined use of NMES, considering exertional hypoxemia, may help improve physical function and activities of daily living. |
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| AbstractList | Introduction: We report a case of a patient with severe hypoxemia after exacerbation of interstitial lung disease (ILD), whose activities of daily living improved with the use of neuromuscular electrical stimulation (NMES).Case presentation: The patient, a 70-year-old male, was hospitalized for exacerbation of ILD, and physical therapy was started on the 15th day of hospitalization. Transferring was possible with light assistance, but walking was difficult. He was independent in eating and used a urinal and a bedpan for defecation. Transcutaneous arterial blood oxygen saturation decreased from 95% to 89% during sitting and standing motions while inhaling 6 L/min of oxygen. Since high-intensity exercise therapy was difficult, NMES was started on the 36th day of hospitalization, taking hypoxemia into consideration.Results: Isometric knee extension muscle strength improved by 4.3-6.2 kgf and continuous walking distance improved to 40 m. The patient became independent in activities of daily living and was discharged home.Conclusion: For patients following an exacerbation of ILD, the combined use of NMES, considering exertional hypoxemia, may help improve physical function and activities of daily living.
はじめに：間質性肺炎増悪後，低酸素血症が著明であった患者に対して骨格筋電気刺激を使用し，日常生活動作が改善した症例を経験したので報告する。症例紹介：間質性肺炎増悪により入院となった70歳代男性，入院15日目より理学療法開始。移乗動作は軽介助で可能であったが歩行は困難であった。食事は自立，排泄は尿器，差し込み便器を使用していた。酸素6L/分吸入下の座位や起立動作で経皮的動脈血酸素飽和度が95%から89%まで低下した。そのため，高強度の運動療法が困難であったことから，低酸素血症に配慮するため，入院36日目より骨格筋電気刺激を開始した。結果：等尺性膝伸展筋力が4.3～6.2kgへ増大し，連続歩行距離が40mまで改善し，日常生活動作が自立し自宅退院となった。まとめ：間質性肺炎増悪後の患者に対する労作時低酸素血症を考慮した骨格筋電気刺激療法の併用は身体機能，日常生活動作改善の一助になると考えられた。 Introduction: We report a case of a patient with severe hypoxemia after exacerbation of interstitial lung disease (ILD), whose activities of daily living improved with the use of neuromuscular electrical stimulation (NMES).Case presentation: The patient, a 70-year-old male, was hospitalized for exacerbation of ILD, and physical therapy was started on the 15th day of hospitalization. Transferring was possible with light assistance, but walking was difficult. He was independent in eating and used a urinal and a bedpan for defecation. Transcutaneous arterial blood oxygen saturation decreased from 95% to 89% during sitting and standing motions while inhaling 6 L/min of oxygen. Since high-intensity exercise therapy was difficult, NMES was started on the 36th day of hospitalization, taking hypoxemia into consideration.Results: Isometric knee extension muscle strength improved by 4.3-6.2 kgf and continuous walking distance improved to 40 m. The patient became independent in activities of daily living and was discharged home.Conclusion: For patients following an exacerbation of ILD, the combined use of NMES, considering exertional hypoxemia, may help improve physical function and activities of daily living. |
| Author | 宇賀 大祐 土橋 邦生 笛木 直人 鈴木 翔太 |
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| References | 2) 植木純，神津玲，大平徹郎，他：呼吸リハビリテーションに関するステートメント．日呼ケアリハ学誌27: 95-114，2018 12) 山下和樹，廣瀬利彦，西上幸裕，他：間質性肺炎の急性増悪患者に対する神経筋電気刺激の効果．日呼ケアリハ誌30: 128-133，2021. 9) Mendoza L, Gogali A, Shrikrishna D, et al.: Quadriceps strength and endurance in fibrotic idiopathic interstitial pneumonia. Respirology 19: 138-43, 2014. 11) 善田督史，津島健司，服部知洋，他：間質性肺疾患に対する神経筋電気刺激と随意運動の併用療法の効果．理学療法科学36: 295-306，2021 6) Ploesteanu RL, Nechita AC, Turcu D, et al.: Effects of neuromuscular electrical stimulation in patients with heart failure - review. J Med Life 11: 107-118, 2018. 15) Keyser RE, Woolstenhulme JG, Chin LM, et al.: Cardiorespiratory function before and after aerobic exercise training in patients with interstitial lung disease. J Cardiopulm Rehabil Prev 35: 47-55, 2015. 3) Burtin C, Decramer M, Gosselink R, et al.: Rehabilitation and acute exacerbations. Eur Respir J 38: 702-712, 2011. 5) Zhang X, Peng Y, Zhong F, et al.: Effects of neuromuscular electrical stimulation on functional capacity and quality of life among patients after cardiac surgery: A systematic review and meta-analysis. J Cardiol 79: 291-298, 2022. 13) Iwakura M, Okura K, Kubota M, et al.: Estimation of minimal clinically important difference for quadriceps and inspiratory muscle strength in older outpatients with chronic obstructive pulmonary disease: a prospective cohort study. Phys Ther Res 24: 35-42, 2020. 10) Jubeau M, Gondin J, Martin A, et al.: Random motor unit activation by electrostimulation. Int J Sports Med 28: 901-904, 2007. 1) 日本呼吸器学会びまん性肺疾患診断・治療ガイドライン作成委員会編：特発性間質性肺炎診断と治療の手引き2022改訂第4版．南江堂，東京，2022，pp.9. 7) Valenzuela PL, Morales JS, Ruilope LM, et al.: Intradialytic neuromuscular electrical stimulation improves functional capacity and muscle strength in people receiving haemodialysis: a systematic review. J Physiother 66: 89-96, 2020. 8) Hill K, Cavalheri V, Mathur S, et al.: Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 5: CD010821, 2018. 14) Oliveira A, Rebelo P, Paixão C, et al.: Minimal Clinically Important Difference for Quadriceps Muscle Strength in People with COPD following Pulmonary Rehabilitation. COPD 18: 35-44, 2021. 4) 横山俊樹，近藤康博：間質性肺炎急性増悪の診断と治療．人工呼吸36: 32-38，2019. 16) Troy LK, Young IH, Lau EM, et al.: Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia. Respirology 21: 1005-1014, 2016. |
| References_xml | – reference: 2) 植木純，神津玲，大平徹郎，他：呼吸リハビリテーションに関するステートメント．日呼ケアリハ学誌27: 95-114，2018． – reference: 6) Ploesteanu RL, Nechita AC, Turcu D, et al.: Effects of neuromuscular electrical stimulation in patients with heart failure - review. J Med Life 11: 107-118, 2018. – reference: 10) Jubeau M, Gondin J, Martin A, et al.: Random motor unit activation by electrostimulation. Int J Sports Med 28: 901-904, 2007. – reference: 13) Iwakura M, Okura K, Kubota M, et al.: Estimation of minimal clinically important difference for quadriceps and inspiratory muscle strength in older outpatients with chronic obstructive pulmonary disease: a prospective cohort study. Phys Ther Res 24: 35-42, 2020. – reference: 5) Zhang X, Peng Y, Zhong F, et al.: Effects of neuromuscular electrical stimulation on functional capacity and quality of life among patients after cardiac surgery: A systematic review and meta-analysis. J Cardiol 79: 291-298, 2022. – reference: 14) Oliveira A, Rebelo P, Paixão C, et al.: Minimal Clinically Important Difference for Quadriceps Muscle Strength in People with COPD following Pulmonary Rehabilitation. COPD 18: 35-44, 2021. – reference: 16) Troy LK, Young IH, Lau EM, et al.: Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia. Respirology 21: 1005-1014, 2016. – reference: 9) Mendoza L, Gogali A, Shrikrishna D, et al.: Quadriceps strength and endurance in fibrotic idiopathic interstitial pneumonia. Respirology 19: 138-43, 2014. – reference: 11) 善田督史，津島健司，服部知洋，他：間質性肺疾患に対する神経筋電気刺激と随意運動の併用療法の効果．理学療法科学36: 295-306，2021． – reference: 8) Hill K, Cavalheri V, Mathur S, et al.: Neuromuscular electrostimulation for adults with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 5: CD010821, 2018. – reference: 7) Valenzuela PL, Morales JS, Ruilope LM, et al.: Intradialytic neuromuscular electrical stimulation improves functional capacity and muscle strength in people receiving haemodialysis: a systematic review. J Physiother 66: 89-96, 2020. – reference: 15) Keyser RE, Woolstenhulme JG, Chin LM, et al.: Cardiorespiratory function before and after aerobic exercise training in patients with interstitial lung disease. J Cardiopulm Rehabil Prev 35: 47-55, 2015. – reference: 12) 山下和樹，廣瀬利彦，西上幸裕，他：間質性肺炎の急性増悪患者に対する神経筋電気刺激の効果．日呼ケアリハ誌30: 128-133，2021. – reference: 4) 横山俊樹，近藤康博：間質性肺炎急性増悪の診断と治療．人工呼吸36: 32-38，2019. – reference: 3) Burtin C, Decramer M, Gosselink R, et al.: Rehabilitation and acute exacerbations. Eur Respir J 38: 702-712, 2011. – reference: 1) 日本呼吸器学会びまん性肺疾患診断・治療ガイドライン作成委員会編：特発性間質性肺炎診断と治療の手引き2022改訂第4版．南江堂，東京，2022，pp.9. |
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| Title | A case of a patient with exacerbation of interstitial lung disease whose activities of daily living were improved by pulmonary rehabilitation with neuromuscular electrical stimulation |
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