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European Heart Journal 2003 24(9):871-878; doi:10.1016/S0195-668X(02)00822-9
Copyright © 2003 by the European Society of Cardiology.
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A randomised study of home-based electrical stimulation of the legs and conventional bicycle exercise training for patients with chronic heart failure

Stuart Harris, John P LeMaitre, Graham Mackenzie, Keith A.A Fox and Martin A Denvir*

Cardiology, Centre for Cardiovascular Research, University of Edinburgh, Edinburgh, UK

* Corresponding author. Cardiology, Western General Hospital, Edinburgh EH4 2XU, UK

Received 18 November 2002; accepted 20 November 2002

Aims Recent guidelines recommend regular exercise in the management of patients with chronic heart failure (CHF). This study was designed to compare the safety and efficacy of conventional bicycle exercise and functional electrical stimulation (FES) of the legs as forms of home-based exercise training for patients with stable CHF.

Methods and results Forty-six patients (38 male) with stable NYHA Class II/III heart failure underwent a 6-week training programme using either a bicycle ergometer or electrical stimulation of the quadriceps and gastrocnemius muscles. In the bike group, significant increases were seen in 6-min walk (44.6m, 95% confidence interval (CI) 29.3–60.9m), treadmill exercise time (110s, 95% CI 72.2–148.0s), maximum leg strength (5.32kg, 95% CI 3.18–7.45kg), and quadriceps fatigue index (0.08, 95% CI 0.04–0.12) following training. In the stimulator group, similar significant increases were seen following training for 6-min walk (40.6m, 95% CI 28.2–53.0m), treadmill exercise time (67s, 95% CI 11.8–121.8s), maximum leg strength (5.35kg, 95% CI 1.53–9.17kg), and quadriceps fatigue index (0.10, 95% CI 0.04–0.17). Peak VO2did not change in either group following training, indicating a low-intensity regime. Quality of life scores improved following training when the bicycle and stimulator groups were considered together, but not when considered separately (–0.43, 95% CI –8.13 to –0.56).

Conclusions FES produces beneficial changes in muscle performance and exercise capacity in patients with CHF. Within this study, the benefits were similar to those observed following bicycle training. FES could be offered to patients with heart failure as an alternative to bicycle training as part of a home-based rehabilitation programme.

Key Words: Heart failure • Exercise training • Electrical stimulation


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