Effects of Neuromuscular Electrical Stimulation on Physiologic and Functional Measurements in Patients With Heart Failure

Neto, Mansueto Gomes; Oliveira, Felipe Assis; Reis, Helena França Correia dos; Rodrigues, Erenaldo de Sousa; Bittencourt, Hugo Souza; Carvalho, Vitor Oliveira

doi:10.1097/hcr.0000000000000151

Cited by 45 publications

(19 citation statements)

References 34 publications

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“…In this regard, the use of neuromuscular electrostimulation (NMES), which is usually used in chronic diseases with secondary sarcopenia, looks promising. [ 4 , 5 ] It has been shown that the use of NMES is not only safe in patients immediately after cardiovascular surgery, [ 6 , 7 ] but also reduces skeletal muscle proteolysis and weakness. [ 8 ] In patients with early activation after cardiovascular surgery, the use of NMES did not lead to additional improvement in muscle strength, which could be due to uncontrolled physical activity in the control.…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery

Сумин¹,

Олейник²,

Безденежных³

et al. 2020

Medicine

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Background: To evaluate the effectiveness of neuromuscular electrical stimulation (NMES) in early rehabilitation of patients with postoperative complications after cardiovascular surgery. Methods: 37 patients (25 men and 12 women) aged 45 to 70 years with postoperative complications after cardiovascular surgery were included in the study. Eighteen patients underwent NMES daily since postoperative day 3 until discharge in addition to standard rehabilitation program (NMES group), and 19 patients underwent standard rehabilitation program only (non-NMES group). The primary outcome was the knee extensors strength at discharge in NMES group and in control. Secondary outcomes were the handgrip strength, knee flexor strength, and cross-sectional area (CSA) of the quadriceps femoris in groups at discharge. Results: Baseline characteristics were not different between the groups. Knee extensors strength at discharge was significantly higher in the NMES group (28.1 [23.8; 36.2] kg on the right and 27.45 [22.3; 33.1] kg on the left) than in the non-NMES group (22.3 [20.1; 27.1] and 22.5 [20.1; 25.9] kg, respectively; P < .001). Handgrip strength, knee flexor strength, quadriceps CSA, and 6 minute walk distance at discharge in the groups had no significant difference. Conclusions: This pilot study shows a beneficial effect of NMES on muscle strength in patients with complications after cardiovascular surgery. The use of NMES showed no effect on strength of non-stimulated muscle, quadriceps CSA, and distance of 6-minute walk test at discharge. Further blind randomized controlled trials should be performed with emphasis on the effectiveness of NEMS in increasing muscle strength and structure in these patients.

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Section: Introductionmentioning

confidence: 99%

Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery

Сумин¹,

Олейник²,

Безденежных³

et al. 2020

Medicine

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“…Twenty two [ 12 – 33 ] MAs reported on change in exercise capacity. Meta-analysis of VO 2peak was performed in 21 publications[ 12 – 16 , 18 – 33 ], 6MWD was analysed in 12 publications[ 12 – 17 , 19 , 20 , 22 , 25 , 28 , 33 ] peak power in two[ 12 , 21 ] and exercise time in one[ 26 ] publication. Analyses examined a range of exercise modalities across heart failure phenotypes, and Review Manager (Revman) was the most popular software package utilised.…”

Section: Resultsmentioning

confidence: 99%

“…Overall eleven [ 12 , 17 , 22 , 23 , 25 – 27 , 29 , 31 – 33 ] MAs failed to report anywhere within the publication any clear approach to deal with missing change SDs. Further examination of the 11 MAs revealed a range of methods were utilised in these analyses, including actual and approximate algebraic recalculations using actual or default p-values, post-intervention SDs and imputed SDs using correlation values ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Reported methods for handling missing change standard deviations in meta-analyses of exercise therapy interventions in patients with heart failure: A systematic review

Pearson

Smart

2018

PLoS ONE

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BackgroundWell-constructed systematic reviews and meta-analyses are key tools in evidenced-based healthcare. However, a common problem with performing a meta-analysis is missing data, such as standard deviations (SD). An increasing number of methods are utilised to calculate or impute missing SDs, allowing these studies to be included in analyses. The aim of this review was to investigate the methods reported and utilised for handling missing change SDs in meta-analyses, using the topic of exercise therapy in heart failure patients as a model.MethodsA systematic search of PubMed, EMBASE and Cochrane Library from 1 January 2014 to 31st March 2018 was conducted for meta-analyses of exercise based trials in heart failure. Studies were eligible to be included if they performed a meta-analysis of change in exercise capacity in heart failure patients after a training intervention.ResultsTwenty two publications performed a meta-analysis on the effect of exercise therapy on exercise capacity in heart failure patients. Eleven (50%) publications did not directly report the approach for dealing with missing change SDs. Approaches reported and utilised to deal with missing change SDs included imputation, actual and approximate algebraic recalculation using study level summary statistics and exclusion of studies.ConclusionChange SDs are often not reported in trial papers and while in the first instance meta-analysts should attempt to obtain missing data from trial authors, this information is frequently not forthcoming. Meta-analysts are then forced to make a decision on how these trials and missing data are to be handled. Whilst not one approach is favoured for dealing with this matter, authors need to clearly report the approach to be utilised for missing change SDs. Where change SDs are imputed meta-analyst are encouraged to explore several options and have a sound rationale as to the choice, and where data is imputed, sensitivity analysis should be conducted.

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“…It is necessary for AHF patients to achieve and maintain optimal physical function, and exercise therapy is required to maintain physical function in HF patients, especially in frail elderly subjects . EMS is a novel intervention that shows beneficial effects on both physical function and exercise capacity . Therefore, we postulated that EMS therapy would be effective in frail elderly AHF patients.…”

Section: Discussionmentioning

confidence: 99%

“…There is a great deal of interest in use of electrical muscle stimulation (EMS), which can safely induce muscle contraction without the volitional effort of the patient, as a new training method that does not evoke dyspnea . Previous reports have indicated that lower‐limb EMS therapy can improve muscle strength, exercise capacity, and health‐related QOL and reduce HF‐related hospitalization in chronic HF patients, including elderly patients . More recently, randomized controlled trials (RCTs) have indicated that a short‐term lower‐limb EMS improved muscle strength, exercise capacity, and health‐related QOL in hospitalized HF patients, including few elderly patients .…”

Section: Introductionmentioning

confidence: 99%

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

Matsue

Yonezawa

et al. 2017

Clinical Cardiology

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In elderly patients with acute heart failure (AHF), clinical outcome is adversely affected by frailty. Although a number of potentially effective interventions for frailty have been reported, little is known about the effects of rehabilitation programs in frail elderly AHF patients. We postulated that addition of electrical muscle stimulation (EMS), which induces muscle contraction without requiring patient volition, to early rehabilitation would be efficacious in frail elderly AHF patients. The ACTIVE‐EMS (Effects of Acute Phase Intensive Electrical Muscle Stimulation in Frail Elderly Patients With AHF; UMIN000019551) trial is a multicenter, randomized controlled trial that will enroll 80 patients from 3 hospitals in Japan. AHF patients age ≥ 75 years positive for frailty, defined as Short Physical Performance Battery score 4 to 9, will be randomly assigned to receive early rehabilitation program only or EMS add‐on therapy for 2 weeks. The primary endpoint of the trial is the change in quadriceps isometric strength between baseline and 2 weeks, with changes in physical function and cognitive function, and clinical safety and feasibility of EMS therapy as secondary outcomes. ACTIVE‐EMS is the first randomized trial to evaluate the clinical effectiveness of adding EMS therapy to early rehabilitation in frail elderly AHF patients. The results of this study will provide insight for the development of appropriate rehabilitation programs for this high‐risk population.

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Effects of Neuromuscular Electrical Stimulation on Physiologic and Functional Measurements in Patients With Heart Failure

Cited by 45 publications

References 34 publications

Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery

Neuromuscular electrical stimulation in early rehabilitation of patients with postoperative complications after cardiovascular surgery

Reported methods for handling missing change standard deviations in meta-analyses of exercise therapy interventions in patients with heart failure: A systematic review

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

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