title: Effects of Neuromuscular Electrical Stimulation on Physiologic and Functional Measurements in Patients With Heart Failure: A SYSTEMATIC REVIEW WITH META-ANALYSIS.
abstract: BACKGROUND
  Neuromuscular electrical stimulation (NMES) is potentially attractive as a method of training in heart failure (HF) and could be performed in patients unable to participate in standard exercise training.
  
  
  OBJECTIVE
  To examine the effects of NMES on physiologic and functional measurements in patients with HF.
  
  
  METHODS
  MEDLINE, Cochrane, EMBASE, Scielo, and PEDro were searched from the earliest date available to July 2014. Two independent reviewers screened the titles and abstracts and selected randomized controlled trials, examining the effects of NMES versus exercise and/or of NMES versus control on physiologic and functional measurements in patients with HF. Two independent reviewers screened the randomized controlled trials. The PEDro score was used to evaluate methodological quality. Weighted mean differences and 95% CI were calculated.
  
  
  RESULTS
  Thirteen studies met the study criteria. Neuromuscular electrical stimulation resulted in improvement in peak oxygen uptake ((Equation is included in full-text article.)O2) (4.86 mL·kg ·min; 95% CI, 2.81-6.91), 6-minute walk test (6MWT) distance (63.54 m; 95% CI, 35.81-91.27), muscle strength (30.74 N; 95% CI, 3.67-57.81), flow-mediated dilatation (2.67%; 95% CI, 0.86-4.49), depressive symptoms (-3.86; 95% CI, -6.46 to -1.25), and global quality of life (0.89; 95% CI, 0.55-1.24). Nonsignificant differences in ((Equation is included in full-text article.)O2) peak, 6MWT, and quality of life were found for participants in the exercise group compared with NMES.
  
  
  CONCLUSIONS
  Neuromuscular electrical stimulation improved peak (Equation is included in full-text article.)O2, 6MWT distance, quality of life, muscle strength, endothelial function, and depressive symptoms in patients with HF and could be considered for inclusion in cardiac rehabilitation for selected patients.
authors.affiliation: Departamento de Biofunção (Dr Gomes Neto, Mr Oliveira, Dr Reis, and Mr Rodrigues), Curso de Fisioterapia da Universidade Federal da Bahia, UFBA, Salvador, Brazil; Programa de Pós Graduação em Medicina e Saúde (Dr Gomes Neto, Mr Rodrigues, and Mr Bittencourt), UFBA, Salvador, BA, Brazil; The GREAT Group (GRupo de Estudos em ATividade física) (Drs Gomes Neto and Carvalho), São Paulo, Brazil; Departamento de Fisioterapia da Universidade Federal de Sergipe (Drs Gomes Neto and Carvalho), UFS, Aracaju, Brazil.
authors.forename: Mansueto
authors.initials: M
authors.lastname: Gomes Neto
authors.forename: Felipe Assis
authors.initials: FA
authors.lastname: Oliveira
authors.forename: Helena França Correia Dos
authors.initials: HF
authors.lastname: Reis
authors.forename: Erenaldo
authors.initials: E
authors.lastname: de Sousa Rodrigues-
authors.forename: Hugo Souza
authors.initials: HS
authors.lastname: Bittencourt
authors.forename: Vitor
authors.initials: V
authors.lastname: Oliveira Carvalho
mesh_terms: D000072038:Cardiac Rehabilitation / Q000379:methods*; D003863:Depression / Q000534:rehabilitation; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy; D006333:Heart Failure / Q000503:physiopathology* / Q000534:rehabilitation*; D006801:Humans; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D010101:Oxygen Consumption; D064797:Physical Conditioning, Human / Q000379:methods*; D011788:Quality of Life; D014664:Vasodilation; D000070857:Walk Test