EFFICACY OF TRANSCUTANEOUS ELECTRICALDIAPHRAGMATIC STIMULATION AND MYOFASCIAL RELEASE ON DIAPHRAGM MOBILITY, PULMONARY FUNCTION TEST PARAMETERS AND ACTIVITY OF DAILY LIVING IN PATIENTS WITH COPD
Description
The present study concludes that Transcutaneous Electrical Diaphragmatic Stimulation (TEDS) combined with Myofascial Release (MFR) is an effective intervention for improving diaphragm mobility, diaphragm thickness, pulmonary function parameters, and activities of daily living in patients with COPD. Significant improvements were observed within both groups; however, the experimental group demonstrated superior outcomes compared to the control group. The findings suggest that TEDS enhances diaphragmatic activation and respiratory muscle performance, while MFR contributes to improved chest wall mobility. The combined effect of these interventions results in better ventilation efficiency and functional capacity. The large effect sizes and high statistical power further support the clinical significance of the intervention. Therefore, TEDS along with MFR can be considered a valuable addition to pulmonary rehabilitation programs for COPD patients.
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Patients were screened through inclusion and exclusion criteria. Outcome measures was taken at baseline and post-intervention. The procedure of the study was explained to all the subjects, and written informed consent was obtained. An information sheet was given to the patients and their caregivers by the therapist to explain the study protocol. Patients were taken from the Respiratory Ward, MMIMSR, MM(DU). Subjects were randomly allocated into group 1 and group 2 through computer-generated random numbers. Group 1 had received TEDS and Myofascial Release Group 2 had received Sham TEDS and Myofascial Release Subjects in each group were informed about the treatment protocol in their native language. The risks and benefits will also be informed to the subject. Each group of patients was received intervention for 3 weeks. In each week, 5 sessions was be given. Every session was of 50 min duration, which consists of 30 min of TEDS and 20 min of MFR. During each session, rectangular electrodes were placed on the parasternal region beside the xiphoid process; the sixth and seventh intercostal spaces in line with the mid‑axillary line. TEDS was performed using a commercial stimulator by applying biphasic waves at a stimulation frequency of 30 Hz, and rise time of 0.7s. TEDS intensity was gradually increased until visible muscle contraction was observed. Participants in the control group received similar electrode placement and intervention duration, except that the stimulator power was off. For the MFR patient was asked to be in a supine position. The therapist was standing at the head end of the patient. Manual contact (pisiform, hypothenar region, and last three fingers) was made with underside of the costal cartilages of the seventh to tenth ribs. While the patient inspires, accompanying the elevation movement of the ribs, the therapist gently pulls the diaphragm along the cephalad direction. And while the patient expires, the therapist deepens the contact towards the inner costal margin. This procedure was followed for the subsequent 10 repetitions, then 1 min rest was given, and again a set of 10 repetitions was performed.
Institutions
- Maharishi Markandeshwar University, MullanaHaryana, Ambāla