title: Efficacy and safety of functional electrical stimulation of lower limb muscles in elderly patients with chronic heart failure: A pilot study.
abstract: BACKGROUND
  Exercise training is an established modality in chronic heart failure. Functional electrical stimulation (FES) is an effective alternative mode of training in patients unwilling or unable to exercise; however, it has not been investigated in elderly patients. We sought to investigate the effects of FES on functional status, quality of life, emotional status and endothelial function in chronic heart failure patients aged 70 years or higher.
  
  
  METHODS
  Thirty patients with stable systolic chronic heart failure (mean age 75 ± 3 years, New York Heart Association (NYHA) class II/III, 37%/63%) randomly underwent a six-week FES training programme or placebo. Questionnaires addressing quality of life (Kansas City Cardiomyopathy Questionnaire (KCCQ), functional and overall) and emotional stress (Zung self-rating depression scale (SDS), Beck Depression Inventory (BDI)), as well as endothelial function (flow-mediated dilatation) were assessed at baseline and upon protocol completion.
  
  
  RESULTS
  A significant improvement in NYHA class (p=0.005), KCCQ-functional (F=68.6, p for interaction<0.001), KCCQ-overall (F=66.9, p<0.001), BDI (F=66.3, p<0.001) and Zung SDS (F=95.1, p<0.001) was observed in the FES group compared to placebo. Patients in the FES group also had a significant increase in flow-mediated dilatation compared with placebo (F=59.1, p<0.01). FES-induced per cent change in flow-mediated dilatation was significantly correlated with respective per cent change in KCCQ functional (r=0.386, p=0.039).
  
  
  CONCLUSIONS
  In this pilot study, FES effectively improved functional status, quality of life, motional stress and endothelial function in elderly chronic heart failure patients and warrants further investigation in this particular group of patients.
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Parissis
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Karavidas
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece dimitrios_farmakis@yahoo.com.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Farmakis
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papoutsidakis
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Vassiliki
authors.initials: V
authors.lastname: Matzaraki
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Sofia
authors.initials: S
authors.lastname: Arapi
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Potamitis
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Nikolaou
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Paraskevaidis
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.affiliation: Department of Cardiology, G Gennimatas Hospital, Athens, Greece.
authors.forename: Vlassios
authors.initials: V
authors.lastname: Pyrgakis
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kremastinos
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Lekakis
authors.affiliation: Heart Failure Unit, Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Filippatos
mesh_terms: D000367:Age Factors; D000368:Aged; D001916:Brachial Artery / Q000503:physiopathology; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004644:Emotions; D004730:Endothelium, Vascular / Q000503:physiopathology; D017079:Exercise Tolerance; D005260:Female; D006115:Greece; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D035002:Lower Extremity; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000098:blood supply / Q000294:innervation*; D010865:Pilot Projects; D011788:Quality of Life; D020127:Recovery of Function; D012039:Regional Blood Flow; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014664:Vasodilation
keywords: Heart failure; elderly; exercise; functional electrical stimulation; rehabilitation