Related Experiment Video
Updated: Mar 8, 2026
A Murine Model of Muscle Training by Neuromuscular Electrical Stimulation
Published on: May 9, 2012
Effects of Neuromuscular Electrical Stimulation During Hemodialysis on Peripheral Muscle Strength and Exercise
Ana Karla Brüggemann1, Carolina Luana Mello1, Tarcila Dal Pont1
1Santa Catarina State University - UDESC, Florianopolis, SC, Brazil.
Insights
Neuromuscular electrical stimulation during hemodialysis improved exercise capacity in chronic kidney disease patients. High-frequency stimulation enhanced muscle strength, while low-frequency stimulation boosted growth factors, indicating strategy-specific benefits.
Area of Science:
- Nephrology
- Rehabilitation Medicine
- Exercise Physiology
Background:
- Chronic kidney disease (CKD) is associated with physical dysfunction and inflammation.
- Hemodialysis patients often experience reduced physical function, impacting quality of life.
Purpose of the Study:
- To assess the impact of high-frequency/intensity versus low-frequency/intensity neuromuscular electrical stimulation (NMES) during hemodialysis on physical function and inflammatory markers in CKD patients.
Main Methods:
- A randomized clinical trial involving 51 CKD patients undergoing hemodialysis.
- Participants received either high-frequency (50Hz) or low-frequency (5Hz) NMES for 12 sessions.
- Outcomes measured included peripheral muscle strength, 6-minute walk test (6MWT), insulin growth factor 1, tumor necrosis factor α, and interleukin 10.
Main Results:
- High-frequency NMES significantly improved peripheral muscle strength, whereas low-frequency NMES did not.
- Both stimulation types increased 6-minute walk test distance, with no significant difference between groups post-intervention.
- Low-frequency NMES elevated insulin growth factor 1, while high-frequency NMES reduced interleukin 10; tumor necrosis factor α remained unchanged.
Conclusions:
- Neuromuscular electrical stimulation during hemodialysis enhances exercise capacity in CKD patients.
- The specific benefits on muscle strength and inflammatory markers depend on the chosen stimulation frequency and intensity.
Objective:
To evaluate the effects of neuromuscular electrical stimulation of high and low frequency and intensity, performed during hemodialysis, on physical function and inflammation markers in patients with chronic kidney disease (CKD).
Design:
Randomized clinical trial.
Setting:
Hemodialysis clinic.
Participants:
Patients with CKD (N=51) were randomized into blocks of 4 using opaque sealed envelopes. They were divided into a group of high frequency and intensity neuromuscular electrical stimulation and a group of low frequency and intensity neuromuscular electrical stimulation.
Interventions:
The high frequency and intensity neuromuscular electrical stimulation group was submitted to neuromuscular electrical stimulation at a frequency of 50Hz and a medium intensity of 72.90mA, and the low frequency and intensity neuromuscular electrical stimulation group used a frequency of 5Hz and a medium intensity of 13.85mA, 3 times per week for 1 hour, during 12 sessions.
Main Outcome Measures:
Peripheral muscle strength, exercise capacity, levels of muscle trophism marker (insulin growth factor 1) and levels of proinflammatory (tumor necrosis factor α) and anti-inflammatory (interleukin 10) cytokines.
Results:
The high frequency and intensity neuromuscular electrical stimulation group showed a significant increase in right peripheral muscle strength (155.35±65.32Nm initial vs 161.60±68.73Nm final; P=.01) and left peripheral muscle strength (156.60±66.51Nm initial vs 164.10±69.76Nm final; P=.02) after the training, which did not occur in the low frequency and intensity neuromuscular electrical stimulation group for both right muscle strength (109.40±32.08Nm initial vs 112.65±38.44Nm final; P=.50) and left muscle strength (113.65±37.79Nm initial vs 116.15±43.01Nm final; P=.61). The 6-minute walk test distance (6MWTD) increased in both groups: high frequency and intensity neuromuscular electrical stimulation group (435.55±95.81m initial vs 457.25±90.64m final; P=.02) and low frequency and intensity neuromuscular electrical stimulation group (403.80±90.56m initial vs 428.90±87.42m final; P=.007). The groups did not differ in peripheral muscle strength and 6MWTD after the training protocol. In the high frequency and intensity neuromuscular electrical stimulation group, a correlation was observed between the initial and final values of 6MWTD and muscle strength. In the low frequency and intensity neuromuscular electrical stimulation group, correlations occurred only between the 6MWTD and the initial muscle strength. Only the low frequency and intensity neuromuscular electrical stimulation group increased levels of insulin growth factor 1 (252.38±156.35pg/mL initial vs 336.97±207.34pg/mL final; P=.03), and only the high frequency and intensity neuromuscular electrical stimulation group reduced levels of interleukin 10 (7.26±1.81pg/mL vs 6.32±1.54pg/mL; P=.03). The groups showed no differences in tumor necrosis factor α levels.
Conclusions:
Patients with CKD on hemodialysis improve exercise capacity after peripheral neuromuscular electrical stimulation of high and low frequency and intensity. However, the benefits on muscle and inflammatory outcomes seem to be specific for the adopted electrical stimulation strategy.
Related Concept Videos
01:24Hemodialysis II: Procedure and Complications
01:25Hemodialysis III: Nursing Management
01:25Hemodialysis I: Introduction
01:27Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
01:15Dialysis
01:20Motor Unit Stimulation
The latent period of contraction marks the onset of excitation-contraction coupling, when the action potential propagates across the sarcolemma, preparing the muscle fibers for contraction. As the fibers enter the contraction phase, the...