Effects of Acute Phase Intensive Electrical Muscle Stimulation in Frail Elderly Patients With Acute Heart Failure (ACTIVE‐EMS): Rationale and protocol for a multicenter randomized controlled trial

Tanaka, Shinya; Matsue, Yuya; Yonezawa, Ryusuke; Saitô, Hiroshi; Hamazaki, Nobuaki; Matsuzawa, Ryota; Nozaki, Kohei; Wakaume, Kazuki; Endo, Yoshiko; Maekawa, Emi; Yamaoka‐Tojo, Minako; Shiono, Takeshi; Inomata, Takayuki; Masuda, Takashi; Ako, Junya

doi:10.1002/clc.22845

Cited by 12 publications

(6 citation statements)

References 46 publications

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“…Other previous studies on EMS, including AHF patients, have mainly used between-subjects comparisons such as randomized controlled trials (RCTs). [17][18][19][20][21][22]36,38) These studies may not be easily adaptable to the actual clinical field because they were targeted at a limited population based on many exclusion criteria and were conducted under specific environmental conditions. In contrast to their findings, our data may be highly versatile in the clinical setting.…”

Section: Discussionmentioning

confidence: 99%

“…The secondary outcome of the study was clinical events (worsening HF or kidney function) during the EMS session. The clinical events were defined as follows: worsening of HF is defined as initiation of intravenous administration of inotropic or vasodilator drugs more than 48 hours after the first intervention and initiation of advanced medical procedures (mechanical circulators, mechanical ventilators, hemodialysis) more than 48 hours after the first intervention; 36) worsening of renal function is defined as an increase in serum creatinine level of 0.3 mg/dL and 25% from baseline. 37) We examined whether these clinical events were related to EMS.…”

Section: Methodsmentioning

confidence: 99%

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Effect of Electrical Muscle Stimulation on the Reduction of Muscle Volume Loss in Acute Heart Failure Patients

Matsuo¹,

Yoneki

Tatsuki³

et al. 2022

Int. Heart J.

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Electrical muscle stimulation (EMS) is expected to be considered as an add-on therapy for the usual rehabilitation of patients with chronic heart failure (HF). However, it remains unclear whether EMS can reduce muscle volume loss in patients with acute HF (AHF) immediately after hospitalization. Therefore, the aim of this study was to investigate if EMS could reduce the lower-limb muscle volume loss in patients with AHF. In this single-center, retrospective, observational study, lower-limb skeletal muscle volume, quadriceps muscle layer thickness, and clinical events (worsening HF or kidney function) were evaluated in 45 patients with AHF (mean age, 77.4 ± 11.6 years, 31 males). All patients underwent EMS on the right leg, in addition to usual rehabilitation, for 20 minutes per day, 5 days per week, for 2 weeks. A two-factor (time × leg) analysis of variance was performed to compare the difference between the right leg (usual rehabilitation and EMS) and left leg (usual rehabilitation only). The skeletal muscle mass decreased by 11.6% ± 19.7% from baseline in the right leg and by 20.4% ± 16.1% in the left leg (interaction; F = 4.54, P = 0.036). The quadriceps muscle layer thickness decreased by 10.2% ± 7.1% from baseline in the right leg and by 13.5% ± 6.0% in the left leg (interaction; F = 10.50, P = 0.002). No clinical events were related to EMS. Results showed that EMS combined with usual rehabilitation for patients with AHF has the potential to inhibit muscle volume loss.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Effect of Electrical Muscle Stimulation on the Reduction of Muscle Volume Loss in Acute Heart Failure Patients

Matsuo¹,

Yoneki

Tatsuki³

et al. 2022

Int. Heart J.

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“…NMES was applied to the muscle groups of both legs, including the quadriceps femoris, hamstrings, tibialis anterior, and triceps surae muscles, using belt electrode skeletal muscle electrical stimulation (Auto TENS Pro; Homer Ion Co., Ltd., Tokyo, Japan). 4) Six silicon-rubber electrode bands were wrapped around the proximal and distal parts of the thigh and distal parts of the lower leg and held in place with hook-and-loop fastener straps (Homer Ion Co.). We set the anode at the thigh's distal part, with the cathode set at the proximal part of the lower leg's thigh and distal part.…”

Section: Case Reportmentioning

confidence: 99%

Hemodynamic Changes During Neuromuscular Electrical Stimulation and Mobility Therapy for an Advanced Heart Failure Patient with Impella 5.0 Device

Nozaki

Hamazaki

Ikeda³

et al. 2021

Int. Heart J.

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The Impella 5.0 is a catheter-mounted left ventricular assist device that is inserted through the patient's subclavian artery. This device allows patient mobilization. Early mobility improves outcomes, including physical function and exercise tolerance, in critically ill patients and those with heart failure (HF). However, there have been no studies regarding the safety of early mobilization during the period of Impella 5.0 insertion based on hemodynamic assessment.A 39-year-old man with idiopathic dilated cardiomyopathy and cardiogenic shock was transferred to our hospital for Impella 5.0 insertion. We started neuromuscular electrical stimulation (NMES) and mobilization eight days after Impella 5.0 insertion. The safety of NMES and mobilization was assessed based on mean blood pressure, heart rate (HR), and mean pulmonary artery pressure measurements as hemodynamic indicators. Muscle strength was also assessed using the Medical Research Council (MRC) scale. Throughout the interventions, only the HR increased slightly during mobilization, and there were no hemodynamic abnormalities. Also, the MRC scale score improved as mobilization progressed. The results presented here suggest that NMES and mobilization are safe and feasible in patients with Impella 5.0 insertion, and therefore should be widely adopted.

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“…Belt electrode skeletal muscle electrical stimulation (B-SES) is a new neuromuscular electrical stimulation (NMES) device that can simultaneously generate muscle contraction of the entire lower limb, compared with conventional muscle contraction, which stimulates contraction of a limited area by pad-type electrodes. [ 4 , 5 ] There are 2 main modes of use: a Disuse mode (stimulation frequency, 20 Hz; pattern of 5 seconds of strong contraction followed by 2 seconds of rest) for strengthening muscles and a metabolic mode (stimulation frequency, 4 Hz; pattern of repeated twitching) for improving metabolism. B-SES is an effective treatment to prevent muscle atrophy and alleviate hypoxia in the entire lower limb, and it is considered an effective treatment strategy to prevent the occurrence of muscular contracture.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of belt electrode skeletal muscle electrical stimulation on muscle flexibility of lower limbs

Tomida

Nakae

2020

Medicine

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Background: Muscular contracture may be caused by immobility-induced muscle atrophy and skeletal muscle hypoxia. Belt electrode skeletal muscle electrical stimulation (B-SES) is a new type of neuromuscular electrical stimulation that can simultaneously contract the lower limb muscle groups, in contrast to the conventional pad-type electrodes. B-SES can suppress muscular atrophy and relieve hypoxia of the skeletal muscle and is considered an appropriate strategy for preventing muscular contracture. However, the effect of B-SES on muscle flexibility has not been verified. This study aimed to compare the immediate effects of B-SES on skeletal muscle flexibility using different stimulation modes before the clinical study. Methods: We conducted a randomized controlled pilot trial with cross-over analysis of 10 healthy subjects. The participants were subjected to three stimulus conditions (Disuse B-SES, Metabolic B-SES, and Control) with a minimal interval of 1 day between interventions, and the lower limb flexibility before and after the B-SES intervention was evaluated. Lower extremity flexibility was evaluated based on the hamstring muscle stiffness and sit-and-reach distance. For each endpoint, within-group comparisons were performed before and after the intervention and were compared between the groups using paired t-tests. Changes in each endpoint before and after the intervention were analyzed using repeated-measures analysis of variance and the Bonferroni method. The significance level was 0.05. Results: Ten healthy individuals participated in all three interventions with a washout period between each intervention. In the Metabolic B-SES group, the sit-and-reach distance after the intervention was significantly higher than that before the intervention (P < 0.05). A comparison of the change in the sit-and-reach distance among the three groups before subsequent tests showed that the Metabolic B-SES group had a significantly increased sit-and-reach distance compared with the control group (P < 0.05). Conclusion: Metabolic B-SES was effective for the immediate improvement of flexibility of the lower limb muscles. Therefore, Metabolic B-SES may be useful as a strategy for preventing muscular contracture.

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Effects of Acute Phase Intensive Electrical Muscle Stimulation in Frail Elderly Patients With Acute Heart Failure (ACTIVE‐EMS): Rationale and protocol for a multicenter randomized controlled trial

Cited by 12 publications

References 46 publications

Effect of Electrical Muscle Stimulation on the Reduction of Muscle Volume Loss in Acute Heart Failure Patients

Effect of Electrical Muscle Stimulation on the Reduction of Muscle Volume Loss in Acute Heart Failure Patients

Hemodynamic Changes During Neuromuscular Electrical Stimulation and Mobility Therapy for an Advanced Heart Failure Patient with Impella 5.0 Device

Efficacy of belt electrode skeletal muscle electrical stimulation on muscle flexibility of lower limbs

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