By Gabriel AusfresserUniversity of Rhode Island

BME 482

Introduction◦ What is Chronic Heart Failure (CHF)?◦ What is Electrical Muscle Stimulation (EMS)?

How does EMS relate to CHF? Research Experiment

◦ Hypothesis◦ Methods◦ Results

Conclusions References

What is Chronic Heart Failure (CHF)?◦ Heart cannot pump sufficient blood and oxygen to

body◦ Results of CHF include

Enlargement of Heart More heart muscle mass Faster heart rate

◦ Symptoms Shortness of Breath Fatigue Weight Gain Ankle Swelling Coughing Exercise Intolerance

CHF Statistics◦ 5.8 million people in U.S. have heart failure◦ 670,000 people are diagnosed every year in U.S.◦ In 2006, CHF contributed to 282,754 deaths

What is Electrical Muscle Stimulation (EMS)?◦ Technique of inducing a muscle contraction◦ Uses an electrical impulse from a device

Impulses mimic action potentials from Central Nervous System

◦ Signals travel down a wire to an electrode Attached to skin in close proximity to muscle that

needs stimulating

Uses for EMS?◦ Electrotherapy

Prevent atrophy after injury◦ Muscle Strength Training

Targets a specific muscle to train Used by athletes

◦ Weight Loss? Proven that EMS does not burn as many calories as a

full-body workout EMS devices are regulated by the FDA

Proven that exercise prolongs life of patients with CHF◦ Allows for more activity throughout the day◦ Unfortunately, most patients with CHF have other

conditions Make conventional exercise very difficult Most patients will not have the desire to exercise

EMS can be used to exercise patients with CHF right from their homes◦ This seems more desirable for CHF patients

Doctors Banerjee, P., Caulfield, B., Crowe, L., and Clark, A. conducted an experiment in 2009◦ Hypothesis:

A home-based EMS training program can effectively improve the health of CHF patients similar to standard exercise programs.

10 Patients◦ Left ventricular systolic dysfunction with New York

Heart Association Class II-III 18 Week Training Program

◦ 1st 8 weeks EMS training – at least one hour a day for 5 days

10 Electrodes placed on legs via tight shorts 9 Volts, rhythmic pulses at 4 Hz, maximum current 300

mA Stimulation of quadriceps, hamstrings, gluteal, and calf

muscles

Next two weeks◦ “Washout period”

No training at all, minimal activity Last 8 weeks

◦ “Control period” Returned to habitual activity

After 1st 8 weeks and after the last 8 weeks, a series of physical tests were taken by the patients◦ Peak oxygen consumption, treadmill walking time,

6-minute walking distance, quadriceps strength, and BMI

Before any training

After EMS training period

After control period

Peak Oxygen Consumption

1.7 L/min 1.8 L/min 1.7 L/min

Treadmill walking time

9 minutes 10.68 minutes 9.38 minutes

6-minute walking distance

415 meters 455 meters 394 meters

Quadriceps strength

377.9 Newtons 404.9 Newtons 363.4 Newtons

BMI 27.9 kg/m^2 27.5 kg/m^2 27.7 kg/m^2

Based on the results:◦ Treadmill walking time increased◦ Peak O2 levels increased◦ 6-minute walking distance increased◦ Quad strength increased◦ BMI decreased

The results are seen after any type of exercise by anyone

EMS successfully increased strength of legs, increased endurance, and lowered the BMI of the patients with CHF

These results will keep the patient healthier and prolong the life of the patient with CHF

The patient can get an efficient workout without leaving her/his house.

Patients who have no motivation for exercise will be able to use EMS training with ease

Only in research phase, but EMS is a possible alternative to strenuous exercise in the future

Banerjee, P., Caulfield, B., Crowe, L., & Clark, A. (2009). Prolonged electrical muscle stimulation exercise improves strength, peak VO2, and exercise capacity in patients with stable chronic heart failure. Journal of Cardiac Failure, 15(4), 319-326. Retrieved from CINAHL database.

http://en.wikipedia.org/wiki/Electro_Muscular_Stimulation http://www.americanheart.org/presenter.jhtml?

identifier=337 http://en.wikipedia.org/wiki/Heart_failure http://www.cdc.gov/dhdsp/library/fs_heart_failure.htm http://www.brownchiro.com/physicaltherapy.htm http://www.nhlbi.nih.gov/.../HF_SignsAndSymptoms.html http://www.topnews.in/health/physicians-uncertain-

therapeutic-approaches-heart-failure-patients-21018