Beneficial Effects of External Muscle Stimulation on Glycaemic Control in Patients with Type 2 Diabetes

Rose, B.; Lankisch, Mark; Herder, C; Röhrig, K.; Kempf, Kerstin; Labrenz, S.; Hänsler, J.; Köenig, Wolfgang; Heinemann, Lutz; Martin, Silas

doi:10.1055/s-2008-1065331

Cited by 12 publications

(11 citation statements)

References 24 publications

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“…17 A related technology, described as 'high frequency NMES', was initially shown to have an effect on HbA1c. 18 Further investigation did not appear to support this claim; however, it may have a beneficial effect on diabetic neuropathies. 19 20 This 'high frequency NMES' appears to have negligible aerobic effect and so would probably have a different mechanism of action.…”

Section: Article Summarymentioning

confidence: 89%

Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study

Crowe

Caulfield

2012

BMJ Open

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ObjectivesA new generation of neuromuscular electrical stimulation (NMES) devices can exercise aerobically at equivalent rates to voluntary exercise. Many with type 2 diabetes cannot or will not exercise sufficiently. The objective of this pilot investigation was to see (1) if it was an acceptable training modality for men with type 2 diabetes mellitus and (2) to assess effects on haemoglobin A1c levels.Design, setting, participants and interventionA case series of eight men with type 2 diabetes mellitus (aged 53±8; body mass index 32±5 5 kg/m2) trained with the NMES system for 1 h 6 times weekly for 8 weeks, unsupervised, at home. There were no other medication or lifestyle interventions. The aerobic NMES exercise system delivers a repeating set of four complex staggered pulses at high intensities (typically 100 mA+) through an array of eight thigh electrodes.Outcome measuresThe primary outcome measures were changes in haemoglobin A1c and the responses in a questionnaire on participants' perceptions of the system. Body mass and composition were also measured before and after the NMES intervention period.ResultsAll participants could use the system at a level that left them breathless and sweaty and with a heart rate over 120 beats per minute. Haemoglobin A1c levels improved by 0.8±0.7% from 7.4±1.3% (mean ± SD) to 6.6±1.0% (p=0.01). All participants considered the system suitable for people with diabetes, would recommend it and would continue to use it twice a week ‘to maintain improvements’.ConclusionsThese results suggest that aerobic NMES may be acceptable and have a beneficial effect on haemoglobin A1c of some men with diabetes. The treatment may be of particular benefit in those who will not or cannot do adequate amounts of voluntary exercise. A randomised control trial is required for conclusive efficacy data.

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Section: Article Summarymentioning

confidence: 89%

Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study

Crowe

Caulfield

2012

BMJ Open

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“…In contrast to TENS the new high tone external muscle stimulation (HTEMS) induces extremely high frequencies ranging from 4,100 to 33,000 Hz which is only associated with vibrations and microcontractions of the muscle fibers and well tolerated. HTEMS, as well as TENS improves the insulin resistance as shown by a lowering of HbA 1C and improved HOMA-IR index in obese diabetic subjects [34].…”

Section: Introductionmentioning

confidence: 96%

High-frequency external muscle stimulation in acute kidney injury (AKI): potential shortening of its clinical course

Iorio¹,

Torraca²,

Gustaferro³

et al. 2012

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Background: The prognosis of acute kidney injury (AKI) is markedly influenced by the degree of muscle protein catabolism. Since the current therapeutic strategies are rather limited, for the first time, we attempted to attenuate the hypercatabolism by high tone electrical muscle stimulation (HTEMS) in AKI patients. This kind of therapy may lower protein degradation via its effect on muscle activity as well as improving insulin resistance. Moreover, electrotherapy may improve renal function due to circulatory effects as well as lowering the sympathetic tone. Methods: 34 patients with AKI Stage 3 were included; all required daily hemodialysis with a dose of Kt/V urea > 1. The patients were randomized into two groups of 17 patients each with and without HTEMS. The groups were comparable with regard to age, gender, underlying diseases, causes of AKI and the baseline biochemistry. HTEMS was performed intradialytically for 1 h. This new electromedical device is characterized by changes in the carrier frequency between 4,100 and 33,000 Hz in short intervals and also the amplitude and frequency are modulated simultaneously. Results: The treatment was well tolerated and associated with an improved clinical outcome. As compared to the untreated patients the HTEMS group showed a significant shorter duration of oliguria, a faster decline of serum creatinine and urea levels, less need of dialysis treatment and a shorter period of hospitalization. The decline of urea was more marked than that of serum creatinine resulting in a significant lowering of the urea/creatinine ratio. This finding suggests a reduced catabolism of muscle proteins which-via a lower release of amino acids into the circulation-results in a decline of hepatic ureagenesis. We hypothesize that in our AKI patients the improved protein catabolism contributed to the shortening of the clinical course of acute re-nal failure. Conclusion: This study suggests for the first time that HTEMS treatment of patients with AKI during hemodialysis is associated with an improved clinical outcome. To support this novel observation, a randomized controlled trial with a greater number of more homogenous AKI patients should be performed.

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“…It is conceivable that a higher dose of HTEMS with its daily application could induce more pronounced effects on the HbA1c and the HRQOL. In fact, in another study with obese diabetic patients daily application of HTEMS was associated with a significant improvement of HbA1c and a lowering of body weight [34].…”

Section: Discussionmentioning

confidence: 94%

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

Klassen¹,

Racasan²,

Gherman-Caprioara³

et al. 2012

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Objective: High-tone external muscle stimulation (HTEMS) has been shown to ameliorate painful peripheral neuropathy of dialysis patients. We hypothesized that HTEMS could also lead to improved parameters of health-related quality of life (HRQOL). Methods: 25 end-stage renal disease (ESRD) patients (17 men/8 women, mean age 62.2 ± 14.2 years) were enrolled for the study. For evaluation of HRQOL the short form SF-36 was used. In addition, the Hospital Anxiety and Depression Scale (HADS) and the pain severity score were investigated. HTEMS was applied intradialytically for 1 hour, 3 times a week. Its effect was evaluated just before the beginning and both 6 and 12 weeks after onset of this study. Results: SF-36 showed a significant effect of time for the subscales of physical role functioning and social functioning. A marginal significant positive trend could be observed for physical functioning. The pain symptom questionnaire sum scores improved significantly after 12 weeks. The HADS did not change significantly. Conclusion: The data indicate that intradialytic HTEMS treatment of ESRD patients with peripheral neuropathy ameliorates various components of physical health.

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Beneficial Effects of External Muscle Stimulation on Glycaemic Control in Patients with Type 2 Diabetes

Cited by 12 publications

References 24 publications

Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study

Aerobic neuromuscular electrical stimulation—an emerging technology to improve haemoglobin A1c in type 2 diabetes mellitus: results of a pilot study

High-frequency external muscle stimulation in acute kidney injury (AKI): potential shortening of its clinical course

High-tone external muscle stimulation in endstage renal disease: effects on quality of life in patients with peripheral neuropathy

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