Addition of Neuromuscular Electrical Stimulation, Based on the Level of Excitability, to an Intradialytic Twice-Weekly Cycling Protocol: A Randomized Trial

Abstract

Background and Purpose: Neuromuscular electrical stimulation (NMES) has shown promise as an adjunct or alternative to traditional training, but its optimal application in chronic kidney disease (CKD) population remains uncertain. This study aimed to compare the effects of the NMES intradialytic protocol combined with a traditional cycling on muscle strength and functional capacity in CKD patients. Methods: Fourteen patients were randomly assigned to either the experimental group (cycling plus NMES) or the control group (cycling only). Treatments were administered twice weekly for 8 weeks. Primary outcomes included muscle strength (isometric manual dynamometry) and functional capacity (1-min sit-stand test). Secondary outcomes included neuromuscular excitability, respiratory muscle strength, and quality of life. Results: After 8 weeks, repeated measures ANOVA showed no significant differences between the groups for any outcomes. Discussion: This study demonstrated that NMES was not superior to the cycling protocol in terms of peripheral muscle strength, functional capacity, neuromuscular excitability, respiratory muscle strength, and quality of life.