Exercise training combined with electromyostimulation in the rehabilitation of patients with chronic heart failure: A randomized trial

Aim. 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. Patients and 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 (10Hz, 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: Delta VO2peak: +12.9%, Delta VO2AT: +9.3%, Delta W-peak : +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 (Delta MLHF: -27.9%; P=0.001), AT+EMS (Delta MLHF: -29.1%; P=0.002), and EMS (Delta 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). Conclusion. No significant difference was found between the two types of exercise training. and nor did, their combination have any significant additional improvement.