Low-Frequency Electrical Stimulation Increases Muscle Strength and Improves Blood Supply in Patients With Chronic Heart Failure

Abstract

hronic congestive heart failure (CHF) is a complex metabolic syndrome resulting from global hypoperfusion and neurohumoral activation. Sympathoadrenergic hyperactivity and stimulation of the reninangiotensin -aldosterone cascade promote endothelial dysfunction in the macro-and microcirculation, and thus influence the distribution of the terminal blood flow. The increased total peripheral resistance, reduction of blood supply and impaired peripheral vascular dilatation in response to vasodilator stimuli result in atrophy of skeletal muscle and decreased oxidative activity. Physical training could reverse the pathologic changes in patients with CHF and there have been many reports during the past decade that clearly demonstrate the benefits of exercise on functional capacity, ventilation, metabolic status, autonomic control of heart rate (HR) variability and other parameCirculation Journal Vol. 70, January 2006 ters, 1-5 including skeletal muscle performance and impaired endothelial function. 6,7 However, most of the actual training protocols are based on systemic exercise requiring increased cardiac output, which cannot be achieved by all patients, and in general are only suitable for patients with a moderately advanced grade of CHF; less attention has been paid to the development of safe and efficient training programs for patients with severe grades of the disease. Background This study was designed to evaluate the effects of low-frequency electrical stimulation (LFES) on muscle strength and blood flow in patients with advanced chronic heart failure (CHF). Methods and ResultsPatients with CHF (n=15; age 56.5±5.2 years; New York Heart Association III -IV; ejection fraction 18.7±3.3%) were examined before and after 6 weeks of LFES (10 Hz) of the quadriceps and calf muscles of both legs (1 h/day, 7 days/week). Dynamometry was performed weekly to determine maximal muscle strength (Fmax; N) and isokinetic peak torque (PTmax; Nm); blood flow velocity (BFV) was measured at baseline and after 6 weeks of LFES using pulsed-wave Doppler velocimetry of the right femoral artery.

Application of neuromuscular electrical stimulation of the lower limb skeletal muscles in the rehabilitation of patients with chronic heart failure and chronic obstructive pulmonary disease

“…In rare cases, patients with class IV symptoms also participated in the research. Some of the participants were either after a heart transplant or qualified for heart transplant surgery [9][10][11][12][13][14][15][16][17][18][19][20].…”

“…The research demonstrated that the application of NMES in patients with CHF results in improvement of exercise tolerance indicators, such as: increased peak oxygen consumption, increased anaerobic threshold, increased duration of exercise tests and greater distance covered during the 6MWT test [9][10][11][12][13][14][15][16][17][18][19][20]. After a series of NMES treatment sessions, increased muscle endurance was also noted in patients with CHF [12].…”

Impact of Aerobic Exercise on Restoration of Soleus and Gastrocnemius Muscles Microcirculations in Wistar Rats with Chronic Heart Failure

“…However, the hypoperfusion phenomenon also further accelerates catabolism, reduces oxidative stress in muscles, decreases intracellular pH, increases production of free radicals and inflammatory cytokines, and leads to cell apoptosis. Meanwhile, chronic hypoxia caused by low systemic blood flow also cause damage to the muscle fibers and eventually leads to atrophy (11). In contrast, endurance exercise training contribute in revascularization of the damaged skeletal muscle through the processes of angiogenesis and arteriolar genesis.…”

Exercise training combined with electromyostimulation in the rehabilitation of patients with chronic heart failure: A randomized trial

“…The first reports on the use of electromyostimulation (EMS) for RHB in CHF patients appeared almost 15 years ago 13 ; at present, there are sufficient arguments for using EMS as an alternative to classical training, in particular in patients with advanced stages of CHF (ref. 14 ). EMS and voluntary muscular contractions (VMC) during bicycle training are two different methods of activating muscle fibers.…”