Nefrología (English Edition) (Jan 2017)

The effect of neuromuscular electrical stimulation on muscle strength, functional capacity and body composition in haemodialysis patients

  • Vicent Esteve,
  • José Carneiro,
  • Fátima Moreno,
  • Miquel Fulquet,
  • Salud Garriga,
  • Mónica Pou,
  • Verónica Duarte,
  • Anna Saurina,
  • Irati Tapia,
  • Manel Ramírez de Arellano

DOI
https://doi.org/10.1016/j.nefroe.2017.01.011
Journal volume & issue
Vol. 37, no. 1
pp. 68 – 77

Abstract

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Introduction: Haemodialysis (HD) patients are characterised by significant muscle loss. Recently, neuromuscular electrical stimulation (NMES) has emerged as a new therapeutic alternative to improve these patients’ physical condition. To date, no studies on the effects of NMES on body composition in HD patients have been published. Objective: To analyse the effect of NMES on muscle strength, functional capacity and body composition in our HD patients. Material and methods: A 12-week, single-centre, prospective study. The patients were assigned to an electrical stimulation (ES) or control (CO) group. The ES group was subjected to intradialytic electrical stimulation of the quadriceps (Compex® Theta 500i), while the CO group received standard HD care. We analysed the following: (1) nutritional parameters; (2) muscle composition of the quadriceps; (3) maximum quadriceps extension strength (mes) and hand-grip (HG); (4) “sit to stand to sit” (STS10) and “six-minute walking test” (6MWT); (5) body composition (bioelectrical impedance analysis). Results: Of 20 patients, 55% were men. Mean age 67.7 years, 30.3 months in HD. Main aetiology: DM (35%). In the ES group were 13 patients, and 7 in the CO group. At the end of the study, an improvement was only observed in the ES group (*p < 0.05): MES* (11.7 ± 7.1 vs. 13.4 ± 7.4 kg), STS10 (39.3 ± 15.5 vs. 35.8 ± 13.7 s) and 6MWT* (9.9%, 293.2 vs. 325.2 m). Furthermore, increased quadriceps muscle area (QMA*: 128.6 ± 30.2 vs. 144.6 ± 22.4 cm2) and lowered quadriceps fat area (QFA*: 76.5 ± 26.9 vs. 62.1 ± 20.1 cm2) were observed. No relevant changes in body composition, nutritional parameters and dialysis adequacy were found. Conclusions: (1) NMES improved muscle strength, functional capacity and quadriceps muscle composition in our patients. (2) Based on the results obtained, NMES could be a new therapeutic alternative to prevent muscle atrophy and progressive physical deterioration. (3) However, future studies are necessary to establish the potential beneficial effects of NMES in HD patients.

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