van Buuren F, Mellwig K P, Fründ A, Bogunovic N, Oldenburg O, Kottmann T, Wagner O, Dahm J B, Horstkotte D, Fritzsche D
Klinik für Kardiologie, Herz- und Diabeteszentrum NRW, Ruhr Universität Bochum, Bad Oeynhausen.
Institut für angewandte Telemedizin (IFAT), Herz und Diabetes Zentrum NRW, Ruhr Universität Bochum, Bad Oeynhausen.
Rehabilitation (Stuttg). 2014 Oct;53(5):321-6. doi: 10.1055/s-0033-1358734. Epub 2013 Dec 20.
Regular physical activity has found to be a strategy to increase exercise capacity in patients with chronic heart failure (CHF). Next to endurance training also electromyostimulation (EMS) of thigh and gluteal muscles results in an increased capacity in CHF patients. EMS therapy was either done by stimulating 8 major muscle groups involving also trunk and arm muscles (extended electromyostimulation (exEMS)) in comparison to EMS therapy limited to gluteal and leg muscles (limEMS).
31 individuals completed the EMS training program. Stable CHF patients (NYHA class II-III) received either exEMS (18 patients, 11 males, mean age 59.8±13.8 years) or limEMS (13 patients, 10 males, 63.6±9.4 years). Training was performed for 10 weeks twice weekly for 20 min, the level of daily activity remained unchanged. Effects on exercise capacity, left ventricular function (EF - ejection fraction) and QoL (quality of life) were evaluated.
QoL was found to be improved in all domains of the SF-36 questionnaire. In the exEMS group there was a significant improvement in the domain physical functioning (54.09±29.9 to 75.45±15.6, p=0.48) and emotional role (63.63±45.8 to 93.93±20.1 p=0.048). LimEMS group showed significant improvement in the domain vitality (37.5±6.9 to 52.8±12.5, p=0.02).There was a significant increase of oxygen uptake at aerobic threshold in all groups (exEMS: +29.6%, p<0.001; limEMS +17.5%, p<0.001). EF -increased from 36.94±8.6 to 42.36±9.1% (+14.7%, p=0.003) in the exEMS group (limEMS 37.7±3.6 to 40.3±5.9% [+6.9%, p=0.18]).
EMS contributes to an improved quality of life and can improve oxygen uptake and EF in CHF. It may be an alternative therapy in CHF patients who are otherwise unable to undertake conventional forms of exercise training.
定期进行体育活动已被视为提高慢性心力衰竭(CHF)患者运动能力的一种策略。除耐力训练外,对大腿和臀肌进行肌电刺激(EMS)也能提高CHF患者的运动能力。与仅限于臀肌和腿部肌肉的EMS治疗(limEMS)相比,EMS治疗还通过刺激包括躯干和手臂肌肉在内的8个主要肌肉群(扩展肌电刺激(exEMS))来进行。
31名个体完成了EMS训练计划。稳定的CHF患者(纽约心脏协会II-III级)接受了exEMS(18例患者,11名男性,平均年龄59.8±13.8岁)或limEMS(13例患者,10名男性,63.6±9.4岁)。训练持续10周,每周两次,每次20分钟,日常活动水平保持不变。评估了对运动能力、左心室功能(EF-射血分数)和生活质量(QoL)的影响。
SF-36问卷所有领域的生活质量均得到改善。在exEMS组中,身体功能领域有显著改善(54.09±29.9至75.45±15.6,p=0.48),情感角色领域也有显著改善(63.63±45.8至93.93±20.1,p=0.048)。limEMS组在活力领域有显著改善(37.5±6.9至52.8±12.5,p=0.02)。所有组的有氧阈值摄氧量均显著增加(exEMS:+29.6%,p<0.001;limEMS:+17.5%,p<0.001)。exEMS组的EF从36.94±8.6增加到42.36±9.1%(+14.7%,p=0.003)(limEMS组从37.7±3.6增加到40.3±5.9%[+6.9%,p=0.18])。
EMS有助于改善生活质量,并可提高CHF患者的摄氧量和EF。对于无法进行传统形式运动训练的CHF患者,它可能是一种替代疗法。