Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart failure - A single-blind, randomized, controlled trial

Objective: To determine the impact of an 8-wk neuromuscular stimulation pro gram of thigh muscles on strength and cross-sectional area in patients with refractory heart failure listed for transplantation. Design: Forty-two patients with a stable disease course were assigned rando mly to a stimulation group (SG) or a control group (CG). The stimulation pr otocol consisted of biphasic symmetric impulses with a frequency of 50 Hz a nd an on/off regime of 2/6 sec. Results: Primary outcome measures were isometric and isokinetic thigh muscl e strength and muscle cross-sectional area. Our results showed an increase of muscle strength by mean 22.7 for knee extensor and by 35.4 for knee flex or muscles. The CG remained unchanged or decreased by -8.4 in extensor stre ngth. Cross-sectional area increased in the SG by 15.5 and in the CG by 1.7 . Conclusions: Activities of daily living as well as quality of life increase d in the SG but not in the CG. Subscales of the SF-36 increased significant ly in the SG, especially concerning physical functioning by +7.5 (1.3-30.0) , emotional role by +33.3 (0-66.6), and social functioning by +18.8 (0-46.9 ), all P < 0.05. Neither a change nor a decrease was observed in the CG. Ne uromuscular electrical stimulation of thigh muscles in patients with refrac tory heart failure is effective in increasing muscle strength and bulk and positively affects the perception of quality of life and activities of dail y living.