Addition of Neuromuscular Electrical Stimulation, Based on the Level of Excitability, to an Intradialytic Twice-Weekly Cycling Protocol: A Randomized Trial.
Beatriz da Costa Ferreira, Clara Narcisa Silva Almeida, Daniel da Costa Torres and 4 others
PMID 41383153WHAT IT FOUND
Adding electrical stimulation to cycling during dialysis did not improve muscle strength, sit-to-stand capacity, breathing muscle strength, neuromuscular excitability, or quality of life versus cycling alone in a very small trial.
Key findings
01Adding chronaxie-based NMES to cycling did not significantly improve peripheral muscle strength, functional capacity, respiratory muscle strength, neuromuscular excitability, or quality of life.
02The intervention group had some positive changes, but they were not statistically significant.
03Adherence was poor: only three of seven intervention participants completed all 16 sessions, and some completed only 25% or 37.5%.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 14 participants were analysed, so the trial is very small. One control participant died, and several participants interrupted or completed only part of the protocol. Participants and therapists could not be blinded to NMES, and only outcome assessors were blinded. Dialysis-related symptoms occurred in 19.6% of control sessions and 28.3% of intervention sessions, which may have limited exercise progression. NMES current was limited by tolerance and produced type 4 contractions rather than the ideal tetanic contractions described by the authors. The planned sample was 6 per group, and the actual analysed sample was 14.
Declared interests
Supported by Federal University of Para through a scholarship program. Authors report no conflicts of interest.
The easy way to misread this
Do not read the small improvements in the NMES group as proof that adding NMES works. The primary outcome was null, and the changes were not statistically significant.
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