80 Abstract Introduction. Chronic obstructive pulmonary disease (COPD) is commonly associated with a vicious circle of sedentary lifestyle - deconditioning - muscular dysfunction. High-frequency neuromuscular electrostimulation has demonstrated beneficial effects among subjects with muscle weakness. This study aimed to evaluate the benefits of merging pulmonary rehabilitation program (PRP) with neuromuscular electrostimulation in patients with very severe COPD. Material and methods. The study included 38 males with clinically stable COPD, who were divided in 2 groups: group A-19 patients that underwent a PRP of 5 sessions/week for 4 weeks and group B-19 patients that underwent intercostal and lower extremity muscle electrostimulation (5 sessions/week for 4 weeks, 60 min /session) in association with the same type of PRP. Saint Georges’s Respiratory Questionnaire (SGRQ), Modified Medical Research Council (mMRC) dyspnea scale, spirometry, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax), six minutes walking test (6MWT) and bio-electrical impedance were examined before and after the intervention. Results. Electrostimulation applied in group B increased muscle mass (50.15 ± 0.61kg vs 53.97 ± 0.87kg, p<0.001)., PEmax (5.41 ± 0.25 vs post 6.79 ± 0.22, p<0.0003) and improved mMRC score (2.68 ± 0.15 vs 2.10 ± 0.15, p<0.0109), 6MWT (369.6 ± 10.77m vs post: 445.6 ± 6.03 m) and SGRQ (61.32 ± 1.83 vs. 44.95 ± 1.94, p<0.0001). In group B only SGRQ score (55.05 ± 1.32 vs. 50.05 ± 1.51, p=0.018) was improved after PRP. Conclusion. A protocol which combines PRP with neuromuscular electrical stimulation in patients with very severe forms of COPD, has grater beneficial effect on dyspnoea, exercise tolerance, muscle mass toning and quality of life, compared with PRP alone. Key words: COPD, muscular dysfunction, neuromuscular electrostimulation, pulmonary rehabilitation program, Introduction In the last century, due to medical innovations, we are facing a decrease in the morbidity and mortality caused by respiratory infections like pneumonia or tuberculosis and a rise in life expectancy (1). On the other hand, in developed countries this phenomenon has led to an increased prevalence of age-related chronic respiratory diseases (2-3): COPD, asthma, emphysema, lung cancer, obstructive sleep apnoea, idiopathic pulmonary fibrosis etc. which represent a significant burden for the health care services (4-10). COPD is a disorder characterized by chronic incomplete reversible airway limitation (11-12). During the chronic evolution of this disease, patients develop dyspnoea, fatigue, limited exercise capacity, symptoms that will lead to a vicious circle of sedentary lifestyle - deconditioning – muscular dysfunction (13,14) Muscle weakness is independent of airflow obstruction severity of and is a significant risk factor for falls in this population (15-16). International guidelines recommend that patients with COPD should be included in PRP, in order to slow down the respiratory decline and to prevent muscle loss (11,12). These programs have been designed to optimize physicalfunction, social performance and autonomy of patients with chronic respiratory diseases. High-frequency neuromuscular electrostimulation has demonstrated beneficial effects among subjects with muscle weakness, especially in quadriceps muscle (17). It can be used alone or in association with other rehabilitation techniques. Study aim The objective of this study was to investigate if the association of neuromuscular electrostimulation to a pulmonary rehabilitation program will have greater benefits on muscle toning and exercise tolerance, then PRP alone, in patients with very severe COPD. Neuromuscular electrostimulation as an adjuvant therapy to pulmonary rehabilitation programs in chronic obstructive pulmonary disease TRĂILĂ Daniel 1 , PESCARU Camelia 1 , SUPPINI POROJAN Noemi 1 , MIHUTA Camil 1 , HOGEA Patricia 1 , CRIŞAN Alexandru 1 , CIUMARNEAN Lorena 2 , MARC Monica 1 Corresponding author: PESCARU Camelia E-mail: camelia.pescaru@yahoo.com 1 “Victor Babeş” University of Medicine and Pharmacy, Timişoara, Romania 2 ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, Romania Balneo Research Journal DOI: http://dx.doi.org/10.12680/balneo.2020.320 Vol.11, No.1, February 2020 p: 80–84