Tai Chi exercise and functional electrical stimulation of lower limb muscles for rehabilitation in older adults with chronic systolic heart failure: a non-randomized clinical trial

Exercise-based training decreases hospitalizations in heart failure patients but such patients have exercise intolerance. The objectives of the study were to evaluate the effect of 12 weeks of Tai Chi exercise and lower limb muscles' functional electrical stimulation in older chronic heart failure adults. A total of 1,084 older adults with chronic systolic heart failure were included in a non-randomized clinical trial (n=271 per group). The control group did not receive any kind of intervention, one group received functional electrical stimulation of lower limb muscles (FES group), another group practiced Tai Chi exercise (TCE group), and another received functional electrical stimulation of lower limb muscles and practiced Tai Chi exercise (FES & TCE group). Quality of life and cardiorespiratory functions of all patients were evaluated. Compared to the control group, only FES group had increased Kansas City Cardiomyopathy Questionnaire (KCCQ) score (P<0.0001, q=9.06), only the TCE group had decreased heart rate (P<0.0001, q=5.72), and decreased peak oxygen consumption was reported in the TCE group (P<0.0001, q=9.15) and FES & TCE group (P<0.0001, q=10.69). FES of lower limb muscles and Tai Chi exercise can recover the quality of life and cardiorespiratory functions of older chronic heart failure adults (trial registration: Research Registry 4474, January 1, 2015).

基于运动的训练可降低心力衰竭患者的住院率，但此类患者普遍存在运动耐量受损问题。本研究旨在评估12周太极拳训练与下肢肌肉功能性电刺激针对老年慢性收缩性心力衰竭成年患者的干预效果。本研究为非随机临床试验，共纳入1084名老年慢性收缩性心力衰竭成年患者，每组271例受试者。对照组未接受任何形式的干预；其中一组接受下肢肌肉功能性电刺激（functional electrical stimulation, FES）干预（FES组），一组开展太极拳训练（Tai Chi exercise, TCE）干预（TCE组），剩余一组同时实施下肢肌肉功能性电刺激与太极拳训练（FES&TCE组）。研究对所有受试者的生活质量与心肺功能进行了评估。与对照组相比，仅FES组的堪萨斯城心肌病问卷（Kansas City Cardiomyopathy Questionnaire, KCCQ）评分显著升高（P<0.0001, q=9.06）；仅TCE组的心率显著降低（P<0.0001, q=5.72）；TCE组（P<0.0001, q=9.15）与FES&TCE组（P<0.0001, q=10.69）的峰值摄氧量均显著下降。下肢肌肉功能性电刺激联合太极拳训练可改善老年慢性收缩性心力衰竭成年患者的生活质量与心肺功能（试验注册：Research Registry 4474，2015年1月1日）。