Far-infrared stimulation of Neiguan acupoints improves heart rate variability and ameliorate fatigue in hemodialysis patients: A randomized trial

Abstract

Background: In 2018, 84,615 patients in Taiwan received hemodialysis, of which about 62% - 97% suffered from fatigue. Fatigue caused by hemodialysis may be mental or physical. However, the detailed mechanism remains unclear. This study aimed to evaluate whether far-infrared stimulation of the neiguan acupoint (P6) could effectively reduce fatigue and improve heart rate variability (HRV) in hemodialysis patients. Methods: We conducted a two-arm, randomized trial in a hemodialysis center between Mar 2015 and Mar 2016. A total of 73 hemodialysis patients were included and were randomly assigned to an experimental group (n=37) and a control group (n=36). The experimental group received far-infrared radiation on neiguan acupoint during hemodialysis for 12 weeks. The outcomes were fatigue level and HRV. Results: All patients showed moderate fatigue (M=26.00 ± 13.01, range=0~78) at baseline. Far-infrared stimulation on neiguan acupoint significantly reduced overall fatigue (β=24, p<0.001) and improved HRV (β=74.36, p<0.001). Compared to the control group, the experiment group had significantly reduced fatigue levels in all aspects such as reduced energy and motivation (β=-2.97, p<0.001), reduced physical strength (β=-1.28, p<0.01), reduced mental capability (β=-2.38, p<0.001), reduction in daily activities (β=-1.48, p<0.01), depressed mood and loss of control (β=-1.21, p<0.05) as well as increased autonomous nervous system activity (β=14.71, p<0.01) in the third month of stimulation. Conclusion: Far-infrared stimulation of the neiguan acupoints effectively reduces fatigue and increases autonomic nervous system activity in hemodialysis patients.