Comparison of Different Intensity Modes of Neuromuscular Electrical Stimulation in the Rehabilitation of Elderly Patients with Decompensated Chronic Heart Failure

Abstract

Aim To compare effects of neuromuscular electrostimulation (NMES) with various intensity of induced muscle contractions on its tolerance and effect on physical work ability in elderly patients admitted for chronic heart failure (CHF).Material and methods The study included 22 patients older than 60 years admitted for decompensated CHF. NMES was performed from the 2nd or 3d day of stay in the hospital to the discharge from the hospital. Patients choose the stimulation regimen themselves based on the result of the first session: the high intensity to achieve maximum tolerable muscle contractions (group 1) or the lower intensity to achieve visible/ palpable muscle contractions (group 2). Prior to the onset and after the completion of the training, the 6-min walk test (6MWT) was performed and the general condition of the patient was assessed with a visual analogue scale (VAS).Results More patients, mostly women, chose the less intensive NMES (14 vs. 8). The groups did not differ in age, comorbidity, and functional condition. Both groups achieved considerable increases in the 6MWT distance (7.3 [5.6; 176] and 9.8 [7.0; 9.9] %, respectively, p>0.05) and VAS scores without a significant difference between the groups. Among the patients who were compliant with continuing NMES after the discharge from the hospital, 69% were patients of the group of the less intensive stimulation.Conclusion The less intensive NMES (with achieving visible muscle contractions) was characterized by better tolerance and better compliance in elderly patients with decompensated CHF compared to the more intensive NMES (with achieving maximum contractions), but the less intensive NMES was not inferior to the more intensive NMES in effectiveness.

Neuromuscular electrical stimulation effect on mRNA expression of skeletal muscle in elderly

“…This issue causes better performance compared to the external stimulus; therefore, the person's balance also increases following these interactions. Also, direct electrical stimulation of the brain in the cerebellar region can affect the membrane potential of glial cells and, as a result, the balance of neurotransmitters (14). This change is similar to what is observed physiologically in astrocytes during the activation of neurons (15).…”

Effects of electrode size and placement on comfort and efficiency during low-intensity neuromuscular electrical stimulation of quadriceps, hamstrings and gluteal muscles

“…The 2 × 2 cm and 5 × 5 cm electrodes were tested on three placements on the quadriceps and hamstrings [ 6 ] and two placements on the gluteus maximus [ 4 ]. The 5 × 9 cm electrodes were placed in a vertical position on the different placements on all three muscle groups and also in a horizontal position on the LT- and L-placement on the quadriceps and hamstrings [ 5 ] as well as both the SL- and LL-placement on the gluteus maximus [ 4 ] and were also tested with one and two cables on all different placements [ 4 ].…”

“…For all the tests both the first visible muscle twitch and the first visible muscle contraction were registered. Based on previous studies using LI-NMES, the level equal to the first visible muscle contraction was thought to be most clinically relevant [ 5 , 7 ]. The results from the first visible muscle twitch were used as a proxy prior to the first muscle contraction, with the purpose to confirm the results from the first visible muscle contraction.…”

“…Low-intensity (LI) NMES (≤ 20 mA), at levels equal to a visible muscle contraction, improve the comfort compared to HI-NMES [ 2 , 5 ]. LI-NMES applied on the lower limbs is known to increase blood circulation [ 6 – 8 ], enhance recovery after exercise [ 3 , 4 ], and improve walking ability among older adults [ 5 ]. However, despite being more comfortable than HI-NMES, LI-NMES may still be perceived as uncomfortable by several patients.…”

Comparison of Effect of Three Different Surgical Procedures on Ankle Joint Function Rehabilitation of Patients with Hepple V Talus Osteochondral Injury

“…It is difficult to repair the defect part of Hepple V talus osteochondral injury. According to Hepple stage, conservative therapy is the preferred treatment for stage III and previous injury treatment, while surgery is required for stage III to stage V [ 6 , 7 ]. Since there is bone cyst formed in Hepple V talus osteochondral injury, conservative therapy alone brings no effect.…”