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

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<.05): MES^* (11.7±7.1 vs. 13.4±7.4kg), STS10 (39.3±15.5 vs. 35.8±13.7s) and 6MWT^* (9.9%, 293.2 vs. 325.2m). Furthermore, increased quadriceps muscle area (QMA^*: 128.6±30.2 vs. 144.6±22.4cm²) and lowered quadriceps fat area (QFA^*: 76.5±26.9 vs. 62.1±20.1cm²) 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.