Aim        To compare effects of neuromuscular electrostimulation (NMES) with various intensity of induced muscle contractions on its tolerance and effect on physical work ability in elderly patients admitted for chronic heart failure (CHF).Material and methods        The study included 22 patients older than 60 years admitted for decompensated CHF. NMES was performed from the 2nd or 3d day of stay in the hospital to the discharge from the hospital. Patients choose the stimulation regimen themselves based on the result of the first session: the high intensity to achieve maximum tolerable muscle contractions (group 1) or the lower intensity to achieve visible/ palpable muscle contractions (group 2). Prior to the onset and after the completion of the training, the 6-min walk test (6MWT) was performed and the general condition of the patient was assessed with a visual analogue scale (VAS).Results   More patients, mostly women, chose the less intensive NMES (14 vs. 8). The groups did not differ in age, comorbidity, and functional condition. Both groups achieved considerable increases in the 6MWT distance (7.3 [5.6; 176] and 9.8 [7.0; 9.9] %, respectively, p>0.05) and VAS scores without a significant difference between the groups. Among the patients who were compliant with continuing NMES after the discharge from the hospital, 69% were patients of the group of the less intensive stimulation.Conclusion            The less intensive NMES (with achieving visible muscle contractions) was characterized by better tolerance and better compliance in elderly patients with decompensated CHF compared to the more intensive NMES (with achieving maximum contractions), but the less intensive NMES was not inferior to the more intensive NMES in effectiveness.

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BackgroundElectrical muscle stimulation (EMS) is being evaluated as a possible alternative to exercise training to improve functional capacity in severely deconditioned patients with heart failure (HF). However, there is insufficient data on delayed effects of EMS starting early after decompensation. The aim of this study was to determine the impact of a short inpatient EMS intervention in severely deconditioned patients with HF on functional capacity and quality of life (QoL) over a follow-up period of 1 month.MethodsThis is a prospective randomised sham-controlled pilot study. 45 patients hospitalised for decompensated systolic HF (58% men, mean age 66.4±10.2 years) were randomised to EMS (n=22) or sham stimulation (n=23) of lower limbs starting within 3 days after admission. The intervention included 7–10 sessions lasting from 30 to 90 min. The 6-minute walking test distance (6-MWTD), Duke Activity Status Index (DASI) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) were evaluated at baseline, discharge and after 1 month.ResultsAll patients completed the programme with good EMS tolerance. 37 patients were included in the final analysis. At discharge, 6-MWTD improved from 206,1±61,3 to 299.5±91 m, DASI from 12.1±5.6 to 18.3±7.2 and MLHFQ from 55.6±8.5 to 34.2±9 with EMS compared with smaller improvements in the sham group (p<0.05 for all). One month after discharge, improvements in the EMS group remained significant for MLHFQ (p=0.004) and DASI (p=0.042) and statistically non-significant for 6-MWTD compared with the sham group.ConclusionsShort-term in-hospital EMS leads to improvements in functional capacity and QoL in selected patients early after HF decompensation that are retained over 1 month after discharge and therefore may serve as initial intervention to improve physical capacity or as a bridge to further conventional exercise training. Larger studies are required to evaluate individual responses to an early initiation of EMS in decompensated HF as well as long-term effects.