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1 4 . H O W T O U S E T H E W I R E L E S S P R O F E S S I O N A L O N S P E C I F I C
I N D I C AT I O N S
241 EN WIRELESS PROFESSIONAL
14.8.4 cardiac rehabilitation
Chronic heart failure causes functional impairment associated with the intricate physiopathological
mechanisms involved between the cardiac dysfunction and the peripheral changes associated with a
deconditioning syndrome.
The skeletal muscle abnormalities are morphological and functional. They include a reduction in muscle
mass, a reduction in slow-twitch type 1 fibres and a reduction in capillary density.
Metabolically, the muscle changes are characterised by a reduction in the density of the mitochondria and
a reduction in the mitochondrial oxidative capacity.
Appropriate physical exercise, which improves one’s capacity for exertion, is known to be one of the
essential components in the treatment of chronic heart failure.
However, some patients are excluded from the cardiac rehabilitation programmes due to the severity
of their cardiac condition or due to co-morbidities limiting the practice of physical exercise. It is because
of this that neuromuscular electrostimulation has been proposed as an alternative or complementary
treatment to physical exercise for heart failure, as it enables muscular performance and capacity for
exertion to be improved.
the protocols proposed have been developed on the basis of the following publications:
1. Karavidas A, Arapi SM, Pyrgakis V, Adamopoulos S.
Functional electrical stimulation of lower limbs in patients with chronic heart failure.
Heart Fail Rev. 2010 Nov;15(6):563-79. Review
2. Banerjee P, Clark A, Witte K, Crowe L, Caulfield B.
Electrical stimulation of unloaded muscles causes cardiovascular exercise by increasing oxygen demand.
Eur J Cardiovasc Prev
Rehabil 2005 ; 12: 503-508
3. Quittan M, Wiesinger G, Sturm B, et al.
Improvement of thigh muscles by neuromuscular electrical stimulation in patients with refractory heart
failure.
Am J Phys Med Rehabil 2001;80(3): 206-214
4. Maillefert JF, Eicher JC, Walker P et al.
Effects of low-frequency electrical stimulation of quadriceps and calf muscles in patients with chronic
heart failure.
J Cardiopulm Rehabil 1998;18(4): 277-282
5. Deley G, Kervio G, Verges B et al.
Comparison of low-frequency electrical myostimulation and conventional aerobic exercise training in
patients with chronic heart failure.
Eur J Cardiovasc Prev Rehabil 2005 ;12(3): 226-233