Material and methods: This study include a group of 60 patients (30 males and 30 females) diagnosed with severe COPD), their age is ranged 40-60 years. The mean ages of the study group (A) (Chest PT) were 47.4 ± 5.7 years and the study group (B) (Chest PT+NMES) are 47.4 ± 5.7 years, they will be randomly divided into two groups; study group (A) 30 patients and study group (B) 30 patients. Study group (A): The patients in this group will receive the chest physiotherapy program for 20 min each day, for five days a week for three consecutive weeks. Study group (B): The patients in this group will receive the same chest physiotherapy program combined with neuromuscular electrical stimulation of quadriceps and calf muscles performed for 30 min /day for five days a week for three consecutive weeks. Femoral blood Flow, quadriceps and calf muscles strength and pulmonary function (FEV1/FVC) will be measured for both groups pre and post treatment.
Background: Patients with COPD often experience skeletal muscle dysfunction. For those who are unable or unwilling to undertake physical training, neuromuscular electrical stimulation (NMES) may provide an alternative method of exercise training.~Objective: To investigate the effects of adding neuromuscular electrical stimulation of quadriceps and calf muscles to chest physiotherapy, compared to chest physiotherapy alone, on muscles strength (quadriceps and calf), femoral blood flow physical and pulmonary function in severe COPD Patients.