Electrical muscle stimulation for chronic heart failure: an alternative tool for exercise training?
Conventional exercise training has been shown conclusively to improve exercise capacity, quality of life, and even reduce mortality in chronic heart failure. Unfortunately, not all heart failure patients are suitable for conventional exercise programs for various reasons. The exciting new technique of electrical muscle stimulation (EMS) of large groups of muscles has been shown to produce a physiologic response consistent with cardiovascular exercise at mild to moderate intensities by increasing peak oxygen consumption, carbon dioxide production, ventilatory capacity, and heart rate. Additionally, there is improvement in muscle strength. The handful of small studies that exist of home-based EMS training of leg muscles in heart failure show that EMS produces similar benefits to conventional exercise in improving exercise capacity, making EMS an alternative to aerobic exercise training in those that cannot undertake conventional exercise. The improvement seen in leg muscle strength promises also to improve mobility in this sedentary population.
Banerjee
Prithwish
P
Department of Cardiology, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK. Prithwish.Banerjee@uhcw.nhs.uk
D004599:Electric Stimulation Therapy; D015444:Exercise; D005081:Exercise Therapy; D006333:Heart Failure / Q000628:therapy*; D006801:Humans
JAMA. 2000 Jun 21;283(23):3095-101
10865304
Circulation. 1987 Nov;76(5):1009-19
3664989
J Appl Physiol (1985). 2002 Jul;93(1):175-80
12070202
Eur J Cardiovasc Prev Rehabil. 2005 Oct;12(5):503-8
16210939
Heart. 1996 May;75(5):469-76
8665339
Circulation. 1986 Aug;74(2):245-51
3731416
Circulation. 1992 Apr;85(4):1364-73
1555280
Eur J Heart Fail. 2008 Jul;10(7):709-13
18558509
Minerva Cardioangiol. 2002 Apr;50(2):95-106
12032463
Circulation. 1966 Oct;34(4):597-608
5950833
Phys Ther. 1988 Oct;68(10):1526-32
3174835
Circulation. 1992 May;85(5):1751-9
1315220
Chest. 2003 Jul;124(1):292-6
12853536
Am J Phys Med Rehabil. 2001 Mar;80(3):206-14; quiz 215-6, 224
11237275
J Am Coll Cardiol. 1996 Sep;28(3):585-90
8772743
J Appl Physiol (1985). 2005 Dec;99(6):2307-11
16081619
Eur Heart J. 2003 May;24(9):871-8
12727155
Circulation. 1989 Nov;80(5):1338-46
2805270
Circulation. 2003 Mar 4;107(8):1210-25
12615804
Spine (Phila Pa 1976). 1992 Jul;17(7):767-70
1502640
Circulation. 1992 Sep;86(3):903-8
1516203
J Am Coll Cardiol. 1997 Apr;29(5):1067-73
9120161
Eur J Cardiovasc Prev Rehabil. 2006 Aug;13(4):592-7
16874150
J Card Fail. 1998 Mar;4(1):9-17
9573499
Prog Cardiovasc Dis. 1982 May-Jun;24(6):437-59
6805039
Eur Heart J. 2004 Jan;25(2):136-43
14720530
Int J Sports Med. 1998 Jul;19(5):317-22
9721054
Circulation. 1991 Nov;84(5):2034-9
1934378
Am J Phys Med Rehabil. 2008 Jun;87(6):502-9
18496251
Eur J Cardiovasc Prev Rehabil. 2005 Jun;12(3):226-33
15942420
Lancet. 1997 Apr 12;349(9058):1050-3
9107242
J Card Fail. 2009 May;15(4):319-26
19398080
Clin Physiol Funct Imaging. 2002 Mar;22(2):92-8
12005161
J Biomed Eng. 1989 Mar;11(2):96-102
2784838
Muscle Nerve. 1992 Mar;15(3):362-7
1557085
Br Heart J. 1991 Jan;65(1):20-4
1993126
Circulation. 1993 Jul;88(1):55-61
8391403
Am J Cardiol. 1995 Jun 15;75(17):1282-3
7778560
Int Heart J. 2006 May;47(3):441-53
16823250
Arch Phys Med Rehabil. 1990 Oct;71(11):863-9
2222153
Circulation. 1991 Oct;84(4):1589-96
1914099
BMJ. 2004 Jan 24;328(7433):189
14729656
JAMA. 2009 Apr 8;301(14):1439-50
19351941
Circulation. 1994 Feb;89(2):836-45
8313573
J Appl Physiol (1985). 1994 Sep;77(3):1288-93
7530705
J Cardiopulm Rehabil. 1998 Jul-Aug;18(4):277-82
9702606
Paraplegia. 1990 May;28(4):235-43
2235031
Crit Care. 2009;13(5):R161
19814793
Br Heart J. 1986 Jan;55(1):75-80
3947485
Phys Ther. 1986 Jun;66(6):937-43
2940607