Effects of Intradialytic Neuromuscular Electrical Stimulation on Strength and Muscle Architecture in Patients With Chronic Kidney Failure: Randomized Clinical Trial

Artif Organs. 2017 Nov;41(11):1049-1058. doi: 10.1111/aor.12886. Epub 2017 Jun 16.

Abstract

This study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) on muscle strength and architecture, functional capacity, and endothelial function in patients with chronic kidney failure (CKF) on hemodialysis (HD). Twenty-one patients with CKF on HD were randomized into a control group (CG; n = 10) and neuromuscular electrical stimulation group (NMESG; n = 11) who received NMES in the quadriceps muscle for 8 weeks, 3 times/week (20-34 min) during HD sessions. The muscle strength of the lower limbs was evaluated by dynamometry and sit-and-stand test (SST); muscle architecture through ultrasonography; functional capacity by the distance covered in a 6-min walk test and the endothelial function by flow-mediated dilatation technique of the brachial artery. There was an increase in the strength of the lower limbs in the NMESG compared to the CG (dynamometry: 43.28 ± 16.94 vs. 35.84 ± 16.89, P = 0.006; SST: 16.10 ± 6.51 vs. 12.50 ± 4.7, P = 0.029). There was a significant reduction in pennation angles of the right vastus lateralis (RVL) and left vastus lateralis (LVL) in the CG when compared to the NMESG (RVL: 11.93 [10.70-15.11] vs. 13.57 [11.81-15.96], P = 0.039; LVL: 11.62 [9.00-14.20] vs. 15.52 [12.86-20.02], P = 0.042). There was no change in functional capacity and in the endothelial function for CG and NMESG, respectively. In conclusion, NMES increases muscle strength and has a protective effect against muscle atrophy of the lower limbs of patients with chronic kidney failure on HD.

Keywords: -Electric stimulation therapy; -Hemodialysis; Chronic kidney disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiopathology
  • Brazil
  • Electric Stimulation Therapy / methods*
  • Endothelium, Vascular / diagnostic imaging
  • Endothelium, Vascular / physiopathology
  • Female
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Muscle Strength Dynamometer
  • Muscle Strength*
  • Muscular Atrophy / diagnostic imaging
  • Muscular Atrophy / etiology
  • Muscular Atrophy / physiopathology
  • Muscular Atrophy / prevention & control*
  • Quadriceps Muscle / diagnostic imaging
  • Quadriceps Muscle / innervation*
  • Recovery of Function
  • Renal Dialysis* / adverse effects
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler
  • Walk Test