The effect of Electrical Stimulation on muscles in patients with Chronic Kidney Disease
- Conditions
- Renal Insufficiency, Chronic
- Registration Number
- RBR-8gj3fkt
- Lead Sponsor
- niversidade Federal do Pará
- Brief Summary
Introduction: Physical training in chronic kidney disease (CKD) has contributed to improving symptoms related to the disease and dialysis treatment. Neuromuscular electrical stimulation is a useful resource, an alternative to traditional exercise, when the patient is unable to perform it efficiently due to clinical condition or frailty. However, the application of stimulation using traditional protocols sometimes does not recruit the ideal number of motor units in larger muscles. In this context, the application of electrical stimulation of muscles based on the level of neuromuscular excitability represented by chronaxia seems to be more effective. Objectives: To evaluate the effects of a chronaxy-based neuromuscular electrical stimulation protocol in addition to a cycling protocol on the physical capacity of people with CKD undergoing hemodialysis. Methods: Randomized, two-arm, parallel-group, allocation-blind, assessor-blinding and intention-to-treat analysis testing the effects of a chronaxy-based cycling and neuromuscular electrical stimulation protocol (intervention group) in comparison with an isolated cycling protocol (control group). Fifteen individuals of both sexes participated, aged = 18 years, diagnosed with CKD on outpatient hemodialysis for at least 3 months. Each group performed a supervised intradialytic exercise protocol for eight weeks, twice a week. Exercise was applied progressively to the control group using a cycle ergometer for the lower limbs, while the same cycling protocol as the control group was applied to the intervention group, and subsequently, neuromuscular electrical stimulation was applied bilaterally to the quadriceps femoris and anterior tibialis muscles, with individualized prescription of pulse width based on the chronaxis obtained in the assessment of neuromuscular excitability. The primary outcomes were peripheral muscle strength and functional capacity. Secondary outcomes were neuromuscular excitability, respiratory muscle strength, and quality of life. Results: There was an increase in peripheral muscle strength of the plantar flexors in the control group after the intervention (8.2 ± 2 vs. 9.3 ± 1.3, p = 0.04). There were no significant differences between groups at the end of the protocol for any of the outcomes evaluated. Conclusion: Neuromuscular electrical stimulation did not promote additional effects to cycling, however, the importance of intradialytic physical exercise is highlighted and the need to explore protocols that take into account changes in neuromuscular excitability related to CKD and optimization of the quality of muscle contraction electrically evoked.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Data analysis completed
- Sex
- Not specified
- Target Recruitment
- Not specified
Volunteers diagnosed with Chronic Kidney Disease (CKD); performing hemodialysis on an outpatient basis; age greater than or equal to 18 years; both sexes; level of functioning with a score greater than or equal to 4 on the Johns Hopkins Highest Level of Mobility Scale (ability to transfer from a bed to an armchair); ability to understand study procedures
Volunteers with a pacemaker or implantable cardioverter-defibrillator; neuromuscular diseases; epilepsy; allergic reactions to electrodes; peripheral edema; ischemia in lower extremities; obesity with a body mass index greater than 35; symptomatic ischemic heart disease; history of myocardial ischemia and angina in the last 6 months; significant valvular heart disease or dysrhythmia; unstable medical condition due to acute or chronic illness
Study & Design
- Study Type
- Intervention
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method
- Secondary Outcome Measures
Name Time Method