title: The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy.
abstract: OBJECTIVE
  Peripheral neuropathy is a devastating uremic complication that causes debilitating pain and movement limitation. The aim of the study was to assess the influence of high-tone external muscle stimulation (HTEMS) therapy on clinical and electrophysiologycal parameters in hemodialysis patients with uremic peripheral neuropathy.
  
  
  METHODS
  The study group consisted of 28 chronic hemodialysis patients (mean age 71.6 ± 8.6 y, median 74 y) on maintenance dialysis for 3 - 187 months (median 31 months). Eight persons (28.9%) were diabetics. All of them exhibited overt peripheral neuropathy and had undergone pharmacological therapy without improvement. All subjects were treated with HTEMS for 1 h during a hemodialysis session, 3 times weekly for 12 weeks. The dialysis parameters (duration of the session, blood and dialysate flow) were constant during the treatment period. Electrophysiological evaluation before and after intervention included assessment of sensory nerves (ulnar nerve, sural nerve) and motor nerves (ulnar nerve, peroneal nerve). The examined nerve conduction parameters were conduction velocity, amplitude, distal latency and F-wave latency.
  
  
  RESULTS
  In the questionnaire 18 persons (64%) reported improvement of general well-being after HTEMS therapy, 17 persons (61%) felt an increase of physical capacity, and 16 persons (57%) experienced a decreased feeling of cold feet. The electrophysiological findings were obtained in 19 patients who completed the examination before and after the course of HTEMS. A significant improvement was noted in the motor conduction velocity of the ulnar nerve; respective values were 48.53 ± 6.14 vs. 51.50 ± 5.51 m/s, p = 0.03.
  
  
  CONCLUSIONS
  The study demonstrated for the first time that the subjective amelioration of uremic peripheral neuropathy by HTEMS treatment is associated with significant improvement in an objective electrophysiological parameter, motor conduction velocity of the ulnar nerve.
authors.affiliation: Department of Nephrology and Transplantation Medicine, and Department of Neurology, Medical University, Wrocław, Poland. b.strempska@mp.pl
authors.forename: Beata
authors.initials: B
authors.lastname: Strempska
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Bilinska
authors.forename: Waclaw
authors.initials: W
authors.lastname: Weyde
authors.forename: Magdalena
authors.initials: M
authors.lastname: Koszewicz
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Madziarska
authors.forename: Tomasz
authors.initials: T
authors.lastname: Golebiowski
authors.forename: Marian
authors.initials: M
authors.lastname: Klinger
mesh_terms: D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000294:innervation / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D009437:Neuralgia / Q000209:etiology / Q000628:therapy; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000628:therapy*; D006435:Renal Dialysis; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000502:physiology; D014511:Uremia / Q000150:complications* / Q000628:therapy*