title: The effect of neuromuscular electrical stimulation on muscle strength, functional capacity and body composition in haemodialysis patients.
abstract: BACKGROUND
  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.
  
  
  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.
authors: Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Barcelona, España; Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España. Electronic address: vestevesimo@gmail.com.
authors: Vicent
authors: V
authors: Esteve
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: José
authors: J
authors: Carneiro
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Fátima
authors: F
authors: Moreno
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Miquel
authors: M
authors: Fulquet
authors: Servei de Rehabilitació Funcional, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Salud
authors: S
authors: Garriga
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Mónica
authors: M
authors: Pou
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Verónica
authors: V
authors: Duarte
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Anna
authors: A
authors: Saurina
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Irati
authors: I
authors: Tapia
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Tarrasa (Barcelona), España.
authors: Manel
authors: M
authors: Ramírez de Arellano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D053581:Muscle Strength Dynamometer; D009133:Muscular Atrophy / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D011446:Prospective Studies; D052097:Quadriceps Muscle / Q000473:pathology / Q000503:physiopathology; D006435:Renal Dialysis / Q000009:adverse effects*; D004561:Transcutaneous Electric Nerve Stimulation
keywords: Body composition; Composición corporal; Electroestimulación neuromuscular; Haemodialysis; Hemodiálisis; Neuromuscular electrical stimulation