Self-directed home-based neuromuscular electrical stimulation (NMES) in patients with advanced cancer and poor performan
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ORIGINAL ARTICLE
Self-directed home-based neuromuscular electrical stimulation (NMES) in patients with advanced cancer and poor performance status: a feasibility study Dominic O’Connor 1,2,3
&
Olive Lennon 1 & Sarah Wright 4 & Brian Caulfield 1,2
Received: 1 November 2019 / Accepted: 17 February 2020 # The Author(s) 2020
Abstract Purpose Concurrent neuromuscular electrical stimulation (NMES) involving sub-tetanic low frequency and tetanic high frequency which targets aerobic and muscular fitness is a potential alternative to conventional exercise in cancer rehabilitation. However, its safety and feasibility in patients with advanced cancer are unknown. The aim of this feasibility study was to determine safety and feasibility and evaluate changes in functional and health-related quality of life (HR-QoL) outcomes in individuals with advanced cancer and poor performance status after concurrent NMES. These results should help inform the design of future studies. Methods Participants with advanced cancer and poor performance status (Eastern Cooperative Oncology Group scale ≥ 2) (n = 18) were recruited. The intervention included a novel NMES intervention implemented over a 4-week period. Functional exercise capacity, lower limb muscle endurance and HR-QoL were measured by 6-min walk test (6MWT), 30-s sit-to-stand (30STS) and European Organization for Research and Treatment quality of life questionnaire core-30 (EORTC QLQ C30) pre and postintervention. Participants unable to complete the 6-min walk test completed the timed up and go test. Participant experience and the impact of the intervention on daily life were investigated through semi-structured interviews. Results Ten of 18 participants completed the intervention. No adverse events were reported. Seven of 8 participants improved 6MWT performance (2 of 2 improved timed up and go), 8 of 10 participants improved 30STS and 8 of 10 participants improved Global quality of life. Perceived benefits included improved mobility and muscle strength. Conclusions Neuromuscular electrical stimulation appears safe and feasible in advanced cancer and may improve physical and HR-QoL outcomes. Future prospective trials are warranted to confirm these findings prior to clinical implementation in an advanced cancer setting. Keywords NMES . Neuromuscular electrical stimulation . Advanced cancer . Rehabilitation . Sit-to-stand . Physical function
Introduction Neuromuscular electrical stimulation (NMES) offers an intuitively appealing alternative to conventional exercises such as * Dominic O’Connor [email protected] 1
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
2
The Insight Centre for Data Analytics, O’Brien Centre for Science, University College Dublin, Dublin, Ireland
3
Queens University, Belfast, Ireland
4
Physiotherapy Department, Beacon Hospital, Dublin, Ireland
aerobic and resistance exercise for clinical populations who find these exercises difficult. Muscle contractions can be achieved without
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