ABSTRACT
Neuromuscular electrical stimulation (NMES) is a form of exercise that uses an electrical current to induced repeated non-voluntary muscle contractions. NMES permits local muscle training at a low cost for the cardiorespiratory system, so is well suited to patients with muscle weakness or breathlessness that limits their ability to participate in more conventional forms of exercise training. NMES training intensity can be optimized using stimulation parameters, but patient tolerance and the intrinsic and fixed properties of the muscle probably play a more important role. The susceptibility to fatigue with NMES also means only a proportion of the total training time is used for active stimulation. Current evidence demonstrates that NMES can improve muscle strength and functional exercise performance, but on its own has limited impact on overall symptom burden or quality of life. Whether prolonged use of NMES can impact on these aspects of health or help bridge patients to return to conventional exercise training remains to be seen. Within pulmonary rehabilitation, routine use as an exercise training adjunct is not supported. Instead, selected use as an exercise training alternative in patients with severely limiting breathlessness is advocated.
