Randomised feasibility trial into the effects of low-frequency electrical muscle stimulation in advanced heart failure patients
MetadataShow full item record
Objectives Low-frequency electrical muscle stimulation (LF-EMS) may have the potential to reduce breathlessness and increase exercise capacity in the chronic heart failure population who struggle to adhere to conventional exercise. The study’s aim was to establish if a randomised controlled trial of LF-EMS was feasible. Design and setting Double blind (participants, outcome assessors), randomised study in a secondary care outpatient cardiac rehabilitation programme. Participants Patients with severe heart failure (New York Heart Association class III–IV) having left ventricular ejection fraction <40% documented by echocardiography were eligible. Interventions Participants were randomised (remotely by computer) to 8 weeks (5×60 mins per week) of either LF-EMS intervention (4 Hz, continuous, n=30) or sham placebo (skin level stimulation only, n=30) of the quadriceps and hamstrings muscles. Participants used the LF-EMS straps at home and were supervised weekly Outcome measures Recruitment, adherence and tolerability to the intervention were measured during the trial as well as physiological outcomes (primary outcome: 6 min walk, secondary outcomes: quadriceps strength, quality of life and physical activity). Results Sixty of 171 eligible participants (35.08%) were recruited to the trial. 12 (20%) of the 60 patients (4 LF-EMS and 8 sham) withdrew. Forty-one patients (68.3%), adhered to the protocol for at least 70% of the sessions. The physiological measures indicated no significant differences between groups in 6 min walk distance(p=0.13) and quality of life (p=0.55) although both outcomes improved more with LF-EMS. Conclusion Patients with severe heart failure can be recruited to and tolerate LF-EMS studies. A larger randomised controlled trial (RCT) in the advanced heart failure population is technically feasible, although adherence to follow-up would be challenging. The preliminary improvements in exercise capacity and quality of life were minimal and this should be considered if planning a larger trial. Trial registration number ISRCTN16749049
Ennis S., McGregor G., Hamborg T., Jones, H., Shave, R., Singh, S. and Banerjee, P. (2017) 'Randomised feasibility trial into the effects of low-frequency electrical muscle stimulation in advanced heart failure patients' BMJ Open 7:e016148
This article was published open access in BMJ Open on 11 August 2017 (online), available at http://dx.doi.org/10.1080/17511321.2017.1351484
Cardiff Metropolitan University (Grant ID: Cardiff Metropolian (Internal))
- Sport Research Groups 
Showing items related by title, author, subject and abstract.
High-intensity interval training versus moderate-intensity steady-state training in UK cardiac rehabilitation programmes (HIIT or MISS UK): study protocol for a multicentre randomised controlled trial and economic evaluation McGregor, Gordon; Nichols, Simon; Hamborg, Thomas; Bryning, Lucy; Tudor-Edwards, Rhiannon; Markland, David; Mercer, Jenny; Birkett, Stefan; Ennis, Stuart; Powell, Richard; Begg, Brian; Haykowsky, Mark J; Banerjee, Prithwish; Ingle, Lee; Shave, Rob; Backx, Karianne (BMJ Publishing Group, 2016-11-16)Introduction Current international guidelines for cardiac rehabilitation (CR) advocate moderate-intensity exercise training (MISS, moderate-intensity steady state). This recommendation predates significant advances in ...
Clinical Lower Limb Alignment in Medial Knee Osteoarthritis and the role of Laterally Wedged Orthoses Fernandes, Gwen (Cardiff Metropolitan University, 2012)Osteoarthritis (OA) often affects the medial tibiofemoral joint (TFJt) of the knee. Foot posture could explain inconclusive study findings evaluating laterally wedged orthoses (LWOs) as an intervention. The overall aim of ...
Evidence from randomised controlled trials did not support the introduction of dietary fat guidelines in 1977 and 1983: A systematic review and meta-analysis Harcombe, Zoe; Baker, Julien; Cooper, Stephen-Mark; Davies, Bruce; Sculthorpe, Nicholas; DiNicolantonio, James; Grace, Fergal (British Medical Journal, 2015)Objectives: National dietary guidelines were introduced in 1977 and 1983, by the United States (US) and United Kingdom (UK) governments respectively, with the ambition of reducing coronary heart disease (CHD) by reducing ...