Real-world experience of feasibility and efficacy of electrical muscle stimulation in elderly patients with acute heart failure: A randomized controlled study

Arenja, Nisha; Müeller, Christian; Tomilovskaya, Elena; Koryak, Yuri; Poltavskaya, M. G.; Saner, Hugo

doi:10.1016/j.ijcard.2021.09.062

Cited by 8 publications

(17 citation statements)

References 26 publications

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“…The main advantage of the EMS approach to rehabilitation is the wide coverage of patients with a variety of medical histories ( Jones et al, 2016 ). The use of EMS is possible even in cases where physical activity is difficult or impossible due to cardiovascular ( Arenja et al, 2021 ; Poltavskaya et al, 2021 ), pulmonary ( Zanotti et al, 2003 ) and other conditions ( Arija-Blazquez et al, 2014 ; Nussbaum et al, 2017 ). Adherence to bed rest has been shown to reduce muscle strength by 5–7% ( Pisot et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

“…EMS has also been shown not only to increase muscle strength but also to reduce lower limb spasticity after stroke ( Moon et al, 2017 ), and a 1-week course of stimulation of the quadriceps femoris and peroneus longus muscles of both legs results in an increase in hip and shin circumferences ( Gerovasili et al, 2009 ). Thus, EMS is a promising treatment/countermeasure modality ( Arenja et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Effect of Modulated Electromyostimulation on the Motor System of Elderly Neurological Patients. Pilot Study of Russian Currents Also Known as Kotz Currents

et al. 2022

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In this brief report, we present preliminary findings from a study of the use of electromyostimulation (EMS) in neurological patients. Assuming the approach to be sufficiently effective, we decided to investigate the motor system of elderly neurological patients before and after a course of Russian currents EMS, which were developed for Soviet athletes and cosmonauts. To this point, 19 patients—EMS (n = 11) and control (n = 8)—have successfully completed the study. The study included patients aged 60–90 years with confirmed walking and balance disorders with a history of chronic cerebral ischemia. Patients in the experimental group underwent a course of modulated EMS of the hip and shin muscles from 3 to 9 procedures. Preliminary results of the study showed good patient acceptance of EMS. After the course, the EMS group showed a significant improvement from baseline in the Tinetti Test (+1.4 points, p = 0.0045), Rivermead Mobility Index (+0.5 points, p = 0.0022), and Timed Up and Go Test (−1.2 s, p = 0.0053). There was also a significant improvement in balance quality of 8.6% (p = 0.04). Shin muscle strength, although trending positively, did not change significantly. There was also no change in hip and shin muscles’ tone. No significant changes were observed in the control group in the same tests. It can be concluded that stimulation of the hip and shin muscles with Russian (Kotz) currents has a positive effect on the motor system of elderly neurological patients. Significant effects with a course of short duration indicate that this EMS regimen is promising.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of Modulated Electromyostimulation on the Motor System of Elderly Neurological Patients. Pilot Study of Russian Currents Also Known as Kotz Currents

et al. 2022

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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%

“…15,[17][18][19] Kondo, et al 17) have recently reported that EMS can be performed safely in AHF patients immediately after hospitalization. Additionally, Arenja, et al 20) observed that EMS improved the 6-minutes walking distance in older adult patients with AHF. Notably, Tanaka, et al 21,22) reported that after the addition of EMS therapy to early rehabilitation in older AHF patients with frailty, an improvement in quadricep isometric strength and shortening of physical performance battery was observed.…”

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confidence: 97%

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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“…Whereas all tolerated EMS well, the burden of study intervention was too high and resulted in a consent rate of < 50% and high dropouts, which limit the interpretability of our data. Less demanding EMS protocols are required to evaluate the full potential of EMS in elderly AHF patients [42].…”

Section: Relative To Therapies In Cardiological Patients and Osteopat...mentioning

confidence: 99%

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

Perrotta¹

2022

J Cardiovasc Med Cardiol

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Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as well as the use of mindful breathing session, osteopathic manipulative treatment, electrical muscle stimulation, low-level tragus stimulation, venoarterial extracorporeal membrane oxygenation, oral nutritional supplements, and the correlative hypothesis between heart failure and intestinal dysbiosis, also concerning the psychological profile. However, these clinical studies suffer from some limitations that will necessarily have to be taken into account, such as the limited size of the population sample selected or the conflict of interest determined by the fact that some research is funded by the same pharmaceutical company producing the drug used that do not necessarily represent a negative limitation on the results obtained from studies.

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Real-world experience of feasibility and efficacy of electrical muscle stimulation in elderly patients with acute heart failure: A randomized controlled study

Cited by 8 publications

References 26 publications

Effect of Modulated Electromyostimulation on the Motor System of Elderly Neurological Patients. Pilot Study of Russian Currents Also Known as Kotz Currents

Effect of Modulated Electromyostimulation on the Motor System of Elderly Neurological Patients. Pilot Study of Russian Currents Also Known as Kotz Currents

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

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

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