Efficacy of enhanced external counterpulsation in patients with chronic obstructive pulmonary disease and bronchial asthma: a pilot study

Chronic obstructive pulmonary disease (COPD) and asthma are associated with decreased exercise tolerance and impaired quality of life. In some patients, even during optimal drug therapy, shortness of breath persists, requiring the development of new non-drug approaches to their management. Objective. To assess the effect of enhanced external counterpulsation on velocity and lung volume indicators, exercise tolerance, and quality of life in patients with chronic obstructive pulmonary disease and asthma. Materials and methods. A pilot randomized study was conducted, which included 50 patients with verified severe and moderate ventilation disorders due to COPD, asthma, and their combination (non-acute). The vast majority of patients (more than 80%) in both groups had COPD. Participants were randomly assigned to the enhanced external counterpulsation (EECP) group (n=25) and the comparison group (n=25). In addition to optimal drug therapy, patients in the EECP group received 20 EECP procedures, and patients in the comparison group received only optimal drug therapy. At baseline and after 1 month, spirometry, body plethysmography, six-minute walk distance, and quality of life were assessed using the SF-36 questionnaire. Results. Two participants in the main group dropped out of the study due to an inability to visit the clinic for procedures; therefore, the analysis included data from 48 participants (23 patients in the EECP group and 25 patients in the control group). A statistically significant improvement in the following indicators was found in the patients of the EECP group: forced expiratory volume in 1 second (FEV1), total lung capacity (TLC), vital capacity (VC), functional residual capacity (FRC), residual volume (RV), specific airway resistance (sRaw), six-minute walk distance, and quality of life according to the SF-36 questionnaire. No statistically significant changes were found in the patients of the comparison group. There were no adverse events associated with EECP. The positive effect is probably associated with improved perfusion of the lungs and respiratory muscles. Conclusion. The study, for the first time, showed a statistically significant improvement in respiratory function, exercise tolerance, and quality of life in patients with chronic obstructive pulmonary disease, asthma, or both after a course of enhanced external counterpulsation. However, given the small sample size of patients with asthma, it is inappropriate to draw conclusions about this cohort.