title: Exercise training combined with electromyostimulation in the rehabilitation of patients with chronic heart failure: A randomized trial.
abstract: OBJECTIVE
  Both aerobic training (AT) and electromyostimulation (EMS) of leg muscles improve exercise tolerance in patients suffering from chronic heart failure (CHF). It was speculated that combination of both methods might have an additive effect. This study was performed to evaluate the effects of a combination of AT and EMS in rehabilitation (RHB) of CHF patients.
  
  
  METHODS
  Patients (n=71; age 59 ± 10.2 yrs, NYHA II/III, EF 32 ± 7.1%) were randomized into 3 groups: a) group AT, b) group EMS, and c) group AT+EMS. AT protocol included standard activity on bicycle 3x a week at the level of individual anaerobic threshold. EMS (10 Hz, mode 20s "on"/20s "off") was applied to leg extensors for 2 h/day. Total time of given type of RHB was 12 weeks.
  
  
  RESULTS
  Data analysis revealed statistically significant improvements of patients in all experimental groups (averaged difference after 12 weeks of exercise as related to initial value: ∆VO2peak: +12.9%, ∆VO2AT: +9.3%, ∆Wpeak: +22.7%). No statistically significant difference among experimental groups was found. Quality of life (Minnesota Living with Heart Failure - MLHF) global score was significantly improved in all 3 groups: AT (∆MLHF: -27.9%; P=0.001), AT+EMS (∆MLHF: -29.1%; P=0.002), and EMS (∆MLHF: -16.6%; P=0.008). MLHF score in EMS group showed the smallest time-related improvement compared to AT and AT+EMS groups, and this difference in improvement between the groups was statistically significant (P=0.021).
  
  
  CONCLUSIONS
  No significant difference was found between the two types of exercise training.and nor did, their combination have any significant additional improvement.
authors.affiliation: Department of Clinical Biochemistry, St. Anne's University Hospital in Brno and Masaryk University, Brno, Czech Republic.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Soska
authors.forename: Petr
authors.initials: P
authors.lastname: Dobsak
authors.forename: Michal
authors.initials: M
authors.lastname: Pohanka
authors.forename: Lenka
authors.initials: L
authors.lastname: Spinarova
authors.forename: Jiri
authors.initials: J
authors.lastname: Vitovec
authors.forename: Jan
authors.initials: J
authors.lastname: Krejci
authors.forename: Petr
authors.initials: P
authors.lastname: Hude
authors.forename: Pavel
authors.initials: P
authors.lastname: Homolka
authors.forename: Marie
authors.initials: M
authors.lastname: Novakova
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Eicher
authors.forename: Jean-Eric
authors.initials: JE
authors.lastname: Wolf
authors.forename: Ladislav
authors.initials: L
authors.lastname: Dusek
authors.forename: Jarmila
authors.initials: J
authors.lastname: Siegelova
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003131:Combined Modality Therapy / Q000379:methods; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D010101:Oxygen Consumption; D011788:Quality of Life