Rehabilitation: Periodic somatosensory stimulation increases arterial baroreflex sensitivity in chronic heart failure patients

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

Research output: Contribution to journalArticlepeer-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 ± 2.61 ms/mm Hg in the TENS group, but did not change in the EXTR group (baseline: 3.37 ± 2.53 ms/mm Hg; effect: 3.26 ± 2.54 ms/mm Hg) (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.

Original languageEnglish
Pages (from-to)237-241
Number of pages5
JournalInternational Journal of Cardiology
Issue number2
Publication statusPublished - Oct 20 2011


  • Autonomic nervous system
  • Baroreflex sensitivity
  • Chronic heart failure
  • Rehabilitation
  • Transcutaneous electrical nerve stimulation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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