Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure: a single-blind, randomized, controlled trial.
OBJECTIVE
To determine the impact of an 8-wk neuromuscular stimulation program of thigh muscles on strength and cross-sectional area in patients with refractory heart failure listed for transplantation.


METHODS
Forty-two patients with a stable disease course were assigned randomly to a stimulation group (SG) or a control group (CG). The stimulation protocol consisted of biphasic symmetric impulses with a frequency of 50 Hz and an on/off regime of 2/6 sec.


RESULTS
Primary outcome measures were isometric and isokinetic thigh muscle strength and muscle cross-sectional area. Our results showed an increase of muscle strength by mean 22.7 for knee extensor and by 35.4 for knee flexor muscles. The CG remained unchanged or decreased by -8.4 in extensor strength. Cross-sectional area increased in the SG by 15.5 and in the CG by 1.7.


CONCLUSIONS
Activities of daily living as well as quality of life increased in the SG but not in the CG. Subscales of the SF-36 increased significantly in the SG, especially concerning physical functioning by +7.5 (1.3-30.0), emotional role by +33.3 (0-66.6), and social functioning by +18.8 (0-46.9), all P < 0.05. Neither a change nor a decrease was observed in the CG. Neuromuscular electrical stimulation of thigh muscles in patients with refractory heart failure is effective in increasing muscle strength and bulk and positively affects the perception of quality of life and activities of daily living.
Department of Physical Medicine and Rehabilitation, University Hospital, Vienna, Austria.
M
M
Quittan
G F
GF
Wiesinger
B
B
Sturm
S
S
Puig
W
W
Mayr
A
A
Sochor
T
T
Paternostro
K L
KL
Resch
R
R
Pacher
V
V
Fialka-Moser
D000203:Activities of Daily Living; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000379:methods*; D004644:Emotions; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000150:complications*; D016027:Heart Transplantation; D006801:Humans; D007537:Isometric Contraction; D007551:Isotonic Contraction; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D009133:Muscular Atrophy / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D016037:Single-Blind Method; D012919:Social Behavior; D013848:Thigh; D016896:Treatment Outcome; D014850:Waiting Lists