Original researchEffects of Neuromuscular Electrical Stimulation During Hemodialysis on Peripheral Muscle Strength and Exercise Capacity: A Randomized Clinical Trial
Section snippets
Methods
This is a randomized, double-blind, controlled trial of patients with CKD who underwent HD. They were divided into 2 groups: patients who were submitted to high frequency and intensity neuromuscular electrical stimulation and patients who were submitted to low frequency and intensity neuromuscular electrical stimulation. Patients were blind to group allocation. Randomization was stratified according to sex, using a block size of 4, and performed using opaque sealed envelopes after the
Results
A total of 51 patients were eligible for the study: 26 patients (51%) were randomized for high frequency and intensity neuromuscular electrical stimulation and 25 (49%) for low frequency and intensity neuromuscular electrical stimulation. Six (23%) and 5 (20%) patients were excluded from the high the frequency and intensity neuromuscular electrical stimulation group and low frequency and intensity neuromuscular electrical stimulation group, respectively. Thus, 40 patients (78%) completed the
Discussion
This study demonstrated that patients with CKD on HD undergoing a high frequency and intensity neuromuscular electrical stimulation therapy as well as those submitted to low frequency and intensity therapy showed increased exercise capacity. However, only the high frequency and intensity neuromuscular electrical stimulation group showed improved peripheral muscle strength.
A relation was found between improved peripheral muscle strength and increased 6MWTD only in the high frequency and
Study limitations
Despite the pair analysis performed in this study, patients in the low frequency and intensity neuromuscular electrical stimulation group showed lower initial peripheral muscle strength than did patients in the high frequency and intensity neuromuscular electrical stimulation group. This chance error could not be controlled, but it has been corrected for the analysis between the groups. The high frequency and intensity neuromuscular electrical stimulation group showed a relation between age and
Conclusions
Patients with CKD on HD improve exercise capacity after peripheral neuromuscular electrical stimulation of high and low frequency and intensity. However, the benefits on muscle and inflammatory outcomes seem to be specific for the adopted electrical stimulation strategy.
Suppliers
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EasyOne portable digital spirometer; ndd Medical Technologies, Inc.
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DuoSet ELISA; R&D Systems, Inc.
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GPower version 3.1.9.2; University of Kiel.
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SPSS version 20.0; IBM Corp.
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Supported by Coordination of Improvement of Higher Level Personnel (CAPES).
Clinical Trial Registration No.: NCT02786849.
Disclosures: none.