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Bio-Electrical Stimulation To Facilitate Improved Training in HF (BESTFIT HF)

Associate Professor Christopher Neil, Institution: University of Melbourne

2017 Vanguard Grant

Years funded: 2018-2020


The current standard of care for Heart Failure (HF) patients in Australia, includes participation in supervised exercise rehabilitation (ER), usually of 8-10 weeks duration.
It is known that gains in aerobic exercise performance translate directly to gains in independent performance of daily activities and increased quality of life, as well as reduced hospitalization and increased survival. However, these benefits are realised in proportion to participation and completion.

A novel technique employing bioelectrical stimulation (BES) of major muscle groups has also been associated with significant functional capacity gains in HF and other disease contexts, achieved with simple take-home equipment and electrodes on the skin, usually for 1 hour per weekday for 3 weeks. Whilst the additive and complimentary potential of BES and ER has been discussed in the literature, no controlled data exists to validate such an approach.

In Australia, where an increasing number of HF patients are frail and elderly, utilizing a period of BES prior to standard ER may enhance training responses and final aerobic capacity, over and above ER alone. Whilst BES + ER would represent an intensification of treatment, 3 weeks of BES would fit neatly into the waiting periods of most ER programs in Australia, without disrupting their flow.
In this pilot study, we will test the feasibility of this approach in a "real world" outpatient setting: we will assess the effect of prior BES on ER participation and achievement of individual patient goals, while collecting objective exercise endpoints and key patient reported measures.

Given the setting, and the deploy ability of the technique, the results are likely to be generalisable and of great interest to the cardiological and rehabilitation communities of Australia.
This pilot may also drive larger appropriately funded multi-centre studies, in order to best inform the optimal care of our patients.

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