Tanaka Shinya, Kamiya Kentaro, Matsue Yuya, Yonezawa Ryusuke, Saito Hiroshi, Hamazaki Nobuaki, Matsuzawa Ryota, Nozaki Kohei, Yamashita Masashi, Wakaume Kazuki, Endo Yoshiko, Maekawa Emi, Yamaoka-Tojo Minako, Shiono Takaaki, Inomata Takayuki, Ako Junya
Department of Rehabilitation, Nagoya University Hospital, Nagoya 466-8560, Japan.
Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Yokohama 252-0373, Japan.
J Cardiovasc Dev Dis. 2022 Mar 27;9(4):99. doi: 10.3390/jcdd9040099.
As frailty in older patients with acute heart failure (AHF) has an adverse effect on clinical outcomes, the addition of electrical muscle stimulation (EMS) to exercise-based early rehabilitation may improve the effects of treatment. Post hoc analysis was performed on a randomized controlled study for clinical outcomes and prespecified subgroups (ACTIVE-EMS: UMIN000019551). In this trial, 31 AHF patients aged ≥ 75 years with frailty (Short Physical Performance Battery [SPPB] score 4-9) were randomized 1:1 to receive treatment with an early rehabilitation program only ( = 16) or early rehabilitation with add-on EMS therapy ( = 15) for 2 weeks. Changes in physical function and cognitive function between baseline and after two weeks of treatment were assessed. There were no adverse events during the EMS period. The EMS group showed significantly greater changes in quadriceps' isometric strength and SPPB compared to the control group, and EMS therapy showed uniform effects in the prespecified subgroups. There were no significant differences in the changes in other indexes of physical function and cognitive function between groups. There was no significant difference in the rate of heart failure hospitalization at 90 days between groups. In conclusion, older AHF patients with frailty showed greater improvement in lower extremity function with the addition of EMS therapy to early rehabilitation without adverse events.
由于急性心力衰竭（AHF）老年患者的衰弱对临床结局有不利影响，在基于运动的早期康复中添加电肌肉刺激（EMS）可能会改善治疗效果。对一项关于临床结局和预先指定亚组的随机对照研究进行了事后分析（ACTIVE-EMS：UMIN000019551）。在该试验中，31名年龄≥75岁且衰弱的AHF患者（简短体能状况量表[SPPB]评分4-9）被随机分为1:1，分别接受仅早期康复计划治疗（ = 16）或早期康复加EMS治疗（ = 15），为期2周。评估了基线与治疗两周后身体功能和认知功能的变化。EMS治疗期间未发生不良事件。与对照组相比，EMS组股四头肌等长力量和SPPB的变化明显更大，并且EMS治疗在预先指定的亚组中显示出一致的效果。两组之间身体功能和认知功能的其他指标变化无显著差异。两组在90天时心力衰竭住院率无显著差异。总之，衰弱的老年AHF患者在早期康复中添加EMS治疗后下肢功能改善更大，且无不良事件。
