Randomised Crossover Trial of Home-Based Neuromuscular Electrical Stimulation Therapy as an Adjunct to Cardiac Rehabilitation in Frail Older Adult Patients With Chronic Heart Failure

Background: Neuromuscular electrical stimulation (NMES) is an alternative therapy for patients unable to perform sufficient voluntary exercises. This randomised crossover study aimed to evaluate the safety and efficacy of home-based NMES as an adjunct to cardiac rehabilitation (CR) for improving physical function in frail older adult patients with chronic heart failure (CHF). Methods and Results: 8 frail older adult patients with CHF underwent 8 weeks of CR supplemented with home-based NMES and 8 weeks of CR alone in random order, separated with a 4-week washout period. NMES at 50-Hz frequency was administered for 50 min/day, 5 times per week, with electrodes placed on the legs. Changes in the short physical performance battery (SPPB) score, leg strength, and the Barthel index were assessed between patients with CR with and without home-based NMES. No NMES-related adverse events were observed. CR with home-based NMES had a higher total SPPB score and 5-repetition sit-to-stand test time of 2.67 points and -10.67 s, respectively, than CR alone (95% confidence interval [CI] 0.3-5.0, P<0.05 and 95% CI -19.5 to -1.3, P<0.05, respectively). No significant leg strength or Barthel index changes were observed between CR with and without home-based NMES. Conclusions: Home-based NMES safely improved physical function in frail older adult patients with CHF.