Comparison of low-frequency electrical myostimulation and conventional aerobic exercise training in patients with chronic heart failure

Deley, Gaëlle; Kervio, Gaëlle; Vergés, B.; Hannequin, Armelle; Petitdant, Marie-France; Salmi-Belmihoub, S.; Grassi, Bruno; Casillas, Jean-Marie

doi:10.1097/01.hjr.0000166455.23346.a5

Cited by 43 publications

(24 citation statements)

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“…Treatment of the patients with CHF through FES training has been proposed as an interesting alternative to CA. Other studies were published in the following years, but generally lacked sufficient power to provide a conclusive answer [10,14,15,21]. The first relevant study in the field was conducted by Harris et al [12], who compared conventional training with FES.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the impossibility of blinding patients and therapists in FES studies, it is possible to blind the evaluation of outcome, which occurred in only three studies [11,14,15]. Deley et al [14] 12/12 56 ± 8/57 ± 6 9/11 9-3-0 Moreover, two studies [10,21] also failed to describe the losses and exclusions that occurred during the treatment period [18,24]. Only the study carried out by Nuhr et al [9] described randomization to be based on a sealed envelope randomization list.…”

Section: Discussionmentioning

confidence: 99%

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Functional electrical stimulation in the treatment of patients with chronic heart failure: a meta-analysis of randomized controlled trials

Sbruzzia

Ribeiro

Schaan

et al. 2010

European Journal of Cardiovascular Prevention & Rehabilitat

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Functional electrical stimulation (FES) produces beneficial effects in the treatment of patients with chronic heart failure (CHF), but studies carried out in these patients show small sample sizes and conflicting results. The aim of this meta-analysis was to systematically review the effect of treatment with FES compared with conventional aerobic exercise training (CA) or control group in patients with CHF. The search strategy included MEDLINE, LILACS, Physiotherapy Evidence Database and Cochrane Library. Randomized trials comparing FES versus CA or control group in the treatment of patients with CHF were included. Two reviewers independently extracted the data. Main analysis used a fixed-effects model. The search retrieved 794 articles, from which seven studies were included. Treatment with FES provided a smaller gain in peak VO2 compared with CA {-0.74 ml/kg per min [95% confidence interval (CI): -1.38 to -0.10]}. There was no difference in the muscle strength [-0.33 Nm (95% CI: -4.56 to 3.90)] and in the distance of the 6-min walk test [2.73 m (95% CI: -15.39 to 20.85)] on comparing FES with CA. An increase in peak VO2 of 2.78 ml/kg per min (95% CI: 1.44-4.13) was observed in FES versus the control group. Treatment with FES provides a similar gain in the distance of the 6-min walk test and in the muscle strength when compared with CA, but a small gain in the peak VO2. An increase in the peak VO2 can be obtained with FES as compared with the control group. Thus, FES may be an alternative in relation with CA for patients with CHF and with those who are unable to perform this kind of exercise.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Functional electrical stimulation in the treatment of patients with chronic heart failure: a meta-analysis of randomized controlled trials

Sbruzzia

Ribeiro

Schaan

et al. 2010

European Journal of Cardiovascular Prevention & Rehabilitat

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“…Maximizing the torque output generated by electrical stimulation is critical, especially when the goals are to achieve muscle strengthening and hypertrophy as an outcome of treatment 4,16,18,30,38. Various clinical trials have shown that increasing the frequency and the amplitude of the current are limited by the rapid onset of muscle fatigue and the subject's tolerance to the delivered current, respectively 8,15,25,32. This would sugest that both parameters can not always be used to maximize torque output.…”

Section: Discussionmentioning

confidence: 99%

“…The common neuromuscular adaptations that characterize the aforementioned conditions are muscle weakness and atrophy resulting from disuse or neurological injury 18,38. NMES protocols consist of a combination of pulse parameters and time modulations to induce muscle contractions that aim to simulate both endurance and resistance training 4,10,15,18. The selection of stimulation parameters is typically based on each patient's rehabilitation goals.…”

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The Role of Pulse Duration and Stimulation Duration in Maximizing the Normalized Torque During Neuromuscular Electrical Stimulation

Gorgey¹,

Dudley²

2008

J Orthop Sports Phys Ther

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Surface neuromuscular electrical stimulation (NMES) is a useful treatment tool in sports medicine and for clinical conditions characterized by motor impairments such as stroke, cerebral palsy, and spinal cord injury. 16,18,30,38,39 The common neuromuscular adaptations that characterize the aforementioned conditions are muscle weakness and atrophy resulting from disuse lation parameters is typically based on each patient's rehabilitation goals. For example, selecting a protocol with pulse frequency of less than 15 Hz could help increase aerobic capacity in patients with heart failure. 15 On the other hand, a frequency greater than 50 Hz is used to increase muscle strength. 16,38 Therefore, studying the parameters that could maximize torque output to attenuate skeletal muscle weakness and atrophy is a key element to the application of NMES.The pulse parameters that are most commonly adjusted to maximize torque output include amplitude of the current, pulse duration, and frequency of the pulses. 8,9,20,23 These parameters characterize the features of a single pulse or series of pulses. 34 In a single pulse, the current amplitude, duration of the pulse, and the shape of the waveform determine the magnitude of the pulse charge of a stimulus. 24 The pulse charge is defined as the current-time integral of the pulse and determines the strength of the stimulus and the evoked torque. 24,34 Laufer et al 27 showed that there was no difference in torque production between monophasic and biphasic waveforms; however, both were superior to the polyphasic waveform. Therefore, in a single waveform the interaction between the amplitude and the pulse duration is critical to the pulse charge. 3 Unlike single pulse, seriesControlled laboratory study.To determine the effects of pulse duration and stimulation duration on the evoked torque after controlling for the activated area by using magnetic resonance imaging (MRI). Neuromuscular electrical stimulation (NMES) is commonly used in the clinic without considering the physiological implications of its parameters.Seven ablebodied, college students (mean SD age, 28 4 years) participated in this study. Two NMES protocols were applied to the knee extensor muscle group in a random order. Protocol A applied 100-Hz, 450-microsecond pulses for 5 minutes in a 3-seconds-on 3-seconds-off duty cycle. Protocol B applied 60-Hz, 250-microsecond pulses for 5 minutes in a 10-seconds-on 20-seconds-off duty cycle. The amplitude of the current was similar in both protocols. Torque, torque time integral, and normalized torque for the knee extensors were measured for both protocols. MRI scans were taken prior to, and immediately after, each protocol to measure the cross-sectional area of the stimulated muscle.The skeletal muscle cross-sectional areas activated after both protocols were similar. The longer pulse duration in protocol A elicited 22% greater torque output than that of protocol B (P .05). After considering the activated area in both protocols, the normalized torque with protocol A was 38%...

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Interventions for preventing critical illness polyneuropathy and critical illness myopathy

Hermans

Jonghe

Bruyninckx

et al. 2014

Cochrane Database of Systematic Reviews

136

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There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the expense of hypoglycaemia. Consequences and prevention of hypoglycaemia need further study. There is moderate quality evidence which suggests no effect of corticosteroids on CIP/CIM and high quality evidence that steroids do not affect secondary outcomes, except for fewer new shock episodes. Moderate quality evidence suggests a potential benefit of early rehabilitation on CIP/CIM which is accompanied by a shorter duration of mechanical ventilation but without an effect on ICU stay. Very low quality evidence suggests no effect of EMS, although data are prone to bias. Strict diagnostic criteria for CIP/CIM are urgently needed for research purposes. Large RCTs need to be conducted to further explore the role of early rehabilitation and EMS and to develop new preventive strategies.

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Comparison of low-frequency electrical myostimulation and conventional aerobic exercise training in patients with chronic heart failure

Abstract: In patients with moderate to severe CHF, 5 weeks of EMS and conventional exercise training produce similar improvements to exercise capacity and muscle performance.

Cited by 43 publications

References 40 publications

Functional electrical stimulation in the treatment of patients with chronic heart failure: a meta-analysis of randomized controlled trials

Functional electrical stimulation in the treatment of patients with chronic heart failure: a meta-analysis of randomized controlled trials

The Role of Pulse Duration and Stimulation Duration in Maximizing the Normalized Torque During Neuromuscular Electrical Stimulation

Interventions for preventing critical illness polyneuropathy and critical illness myopathy

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