Acu-TENS is a new form of Neuromuscular Electrical Stimulation applied over the traditional acupuncture points. The latest ATS/ERS guidelines published this 2013 mentioned Acu-TENS as an adjunct to Pulmonary Rehabilitation. Excluding the experimental data, there is no data regarding its application in clinical practice.
Discussion: This is a case of a 65 yo male diagnosed with stable moderate, COPD C referred to Pulmonary Rehabilitation because of dyspnea on ambulation. He underwent Acu-TENS treatment 3 x a week for 12 sessions (4weeks). Using low frequency 9HZ continuous current applied over lateral of the 7th cervical vertebrae called the EX-B1. Post-intervention patient noted a decrease in use of rescue medications and was able to walk two flights of stairs without shortness of breath. The mechanism of B-endorphin release, a bronchodilator, post Acu-TENS that increases FEV1 is the proposed mechanism for this improvement of dyspnea. This was objectively seen as an improvement in his CAT score of 12 from 15. An enhanced quality of life measured through SGRQ was evident as score declined from 19 to 29. Bode Index of the patient decreased from 2 to1 which reflects a decrease risk for death. His 6 minute walk test post-assessment was 443 meters from 400 meters with no breathlessness. Although, there was an increase in his 6 minute walk test, it was not a significant expected response post-Rehabilitation program of 50 meters. This is an expected finding since there was no structured exercise specific to the lower extremities aside from walking which may be a submaximal form of exercise to elicit improvement in the 6 minute walk test.
Conclusion: Acu-TENS treatment 3 x a week for 12 sessions (4weeks) was sufficient to achieve clinical response in our patient in terms of improvement of symptoms, quality of life and decrease risk of death. However, the use of Acu-TENS alone may not be as efficacious compared to a structured Pulmonary Rehabilitation program in terms of exercise capacity. It may be used as an adjunct an alternative form of Rehabilitation of moderate COPD patients