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Rehabilitation: Periodic somatosensory stimulation increases arterial baroreflex sensitivity in chronic heart failure patients.
MedLine Citation:
PMID:  20691484     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: One of the beneficial effects of exercise training in chronic heart failure (CHF) is an improvement in baroreflex sensitivity (BRS), a prognostic index in CHF. In our hypothesis-generating study we propose that at least part of this effect is mediated by neural afferent information, and more specifically, by exercise-induced somatosensory nerve traffic.
OBJECTIVE: To compare the effects of periodic electrical somatosensory stimulation on BRS in patients with CHF with the effects of exercise training and with usual care.
METHODS: We compared in stable CHF patients the effect of transcutaneous electrical nerve stimulation (TENS, N=23, LVEF 30±9%) with the effects of bicycle exercise training (EXTR, N=20, LVEF 32±7%). To mimic exercise-associated somatosensory ergoreceptor stimulation, we applied periodic (2/s, marching pace) burst TENS to both feet. TENS and EXTR sessions were held during two successive days.
RESULTS: BRS, measured prior to the first intervention session and one day after the second intervention session, increased by 28% from 3.07±2.06 to 4.24±2.61ms/mmHg in the TENS group, but did not change in the EXTR group (baseline: 3.37±2.53ms/mmHg; effect: 3.26±2.54ms/mmHg) (P(TENS vs EXTR)=0.02). Heart rate and systolic blood pressure did not change in either group.
CONCLUSIONS: We demonstrated that periodic somatosensory input alone is sufficient and efficient in increasing BRS in CHF patients. This concept constitutes a basis for studies towards more effective exercise training regimens in the diseased/impaired, in whom training aimed at BRS improvement should possibly focus more on the somatosensory aspect.
Maaike G J Gademan; Yiping Sun; Liming Han; Vanessa J Valk; Martin J Schalij; Henk J van Exel; Carolien M H B Lucas; Arie C Maan; Harriette F Verwey; Hedde van de Vooren; Gian D Pinna; Roberto Maestri; Maria Teresa La Rovere; Ernst E van der Wall; Cees A Swenne
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Publication Detail:
Type:  Journal Article     Date:  2010-08-09
Journal Detail:
Title:  International journal of cardiology     Volume:  152     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  237-41     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
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