This study is a randomized controlled trial designed to evaluate the effects of combined diaphragmatic and abdominal neuromuscular electrical stimulation (NMES) on arterial blood gases, pulmonary function, left ventricular ejection fraction, and functional capacity in patients following percutaneous coronary intervention (PCI). A total of 42 participants will be randomly allocated into two groups: an intervention group receiving NMES along with standard cardiac rehabilitation, and a control group receiving standard rehabilitation alone. The intervention will be administered for 30 minutes per session, five days per week, over a period of two weeks. Outcome measures will include arterial blood gas parameters (PaO₂, PaCO₂, SaO₂), spirometry indices (FVC, FEV₁, PEFR), ejection fraction assessed by echocardiography, and functional capacity measured using the 6-minute walk test. Assessments will be conducted at baseline and post-intervention. The study aims to determine whether NMES can serve as an effective adjunct to conventional cardiac rehabilitation in improving respiratory and functional outcomes in post-PCI patients.
Patients aged 40-75 years
Patients who have undergone successful percutaneous coronary intervention (PCI) for stable or acute coronary syndrome
Hemodynamically stable (no inotropic support, no active arrhythmias)
Left ventricular ejection fraction (LVEF) ≥ 35%
Significant arrhythmias or pacemaker/implantable defibrillator not cleared for NMES
Severe pulmonary disease (e.g., advanced COPD, pulmonary fibrosis) affecting lung function independently
Neuromuscular disorders interfering with NMES application
Recent stroke or severe cognitive impairment limiting participation
Parallel
Neuromuscular Electrical Stimulation (NMES)
DeviceA dual-channel electrical stimulation device will be used to deliver stimulation to respiratory muscles. Surface electrodes will be placed over the lower thoracic region for diaphragmatic stimulation and over the abdominal muscles for expiratory muscle stimulation. Stimulation parameters will include a frequency of 30-50 Hz, pulse width of 300 µs, and a duty cycle of 5 seconds on and 5 seconds off. Intensity will be adjusted to achieve visible muscle contraction without discomfort. Sessions will last 30 minutes, five days per week, for two weeks.
Standard Cardiac Rehabilitation
Other interventionA structured cardiac rehabilitation program including aerobic exercise, breathing exercises, and patient education delivered according to institutional protocols, without the use of neuromuscular electrical stimulation.
Partial Pressure of Oxygen (PaO₂)
Measurement of arterial partial pressure of oxygen using arterial blood gas analysis.
Partial Pressure of Carbon Dioxide (PaCO₂)
Measurement of arterial partial pressure of carbon dioxide using arterial blood gas analysis.
Arterial Oxygen Saturation (SaO₂)
Measurement of arterial oxygen saturation using arterial blood gas analysis.
Forced Vital Capacity (FVC)
Assessment of forced vital capacity using spirometry.
Left Ventricular Ejection Fraction (LVEF)
Measurement of cardiac function using echocardiography (Simpson's biplane method).
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