High-Tone External Muscle Stimulation in End-Stage Renal Disease: Effects on Symptomatic Diabetic and Uremic Peripheral Neuropathy

Klassen, André; Iorio, Biagio Di; Guastaferro, P.; Bahner, Udo; Heidland, A.; Santo, Natale De

doi:10.1053/j.jrn.2007.10.010

Cited by 24 publications

(18 citation statements)

References 24 publications

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“…In the context of the lack of effective pharmacological treatment of peripheral ure-mic neuropathy, HTEMS may be appraised as a promising tool. Our results confirm the conclusion from a previous study concerning patients' subjective feeling of amelioration of peripheral neuropathy symptoms after HTEMS therapy [6]. In the questionnaire of self-evaluation of HTEMS course effects, 18 persons (64%) reported a general improvement of well-being after HTEMS therapy, 17 persons (61%) felt an increase of physical capacity and 16 persons (57%) experienced a decreased feeling of cold feet.…”

Section: Discussionsupporting

confidence: 89%

The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

Strempska¹,

Bilińska²,

Weyde³

et al. 2012

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Objective and design: Peripheral neuropathy is a devastating uremic complication that causes debilitating pain and movement limitation. The aim of the study was to assess the influence of high-tone external muscle stimulation (HTEMS) therapy on clinical and electrophysiologycal parameters in hemodialysis patients with uremic peripheral neuropathy. Patients and interventions: The study group consisted of 28 chronic hemodialysis patients (mean age 71.6 ± 8.6 y, median 74 y) on maintenance dialysis for 3 -187 months (median 31 months). Eight persons (28.9%) were diabetics. All of them exhibited overt peripheral neuropathy and had undergone pharmacological therapy without improvement. All subjects were treated with HTEMS for 1 h during a hemodialysis session, 3 times weekly for 12 weeks. The dialysis parameters (duration of the session, blood and dialysate flow) were constant during the treatment period. Electrophysiological evaluation before and after intervention included assessment of sensory nerves (ulnar nerve, sural nerve) and motor nerves (ulnar nerve, peroneal nerve). The examined nerve conduction parameters were conduction velocity, amplitude, distal latency and F-wave latency. Results: In the questionnaire 18 persons (64%) reported improvement of general well-being after HTEMS therapy, 17 persons (61%) felt an increase of physical capacity, and 16 persons (57%) experienced a decreased feeling of cold feet. The electrophysiological findings were obtained in 19 patients who completed the examination before and after the course of HTEMS. A significant improvement was noted in the motor conduction velocity of the ulnar nerve; respective values were 48.53 ± 6.14 vs. 51.50 ± 5.51 m/s, p = 0.03. Conclusion: The study demonstrated for the first time that the subjective amelioration of uremic peripheral neuropathy by HTEMS treatment is associated with significant improvement in an objective electrophysiological parameter, motor conduction velocity of the ulnar nerve.

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Section: Discussionsupporting

confidence: 89%

The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

Strempska¹,

Bilińska²,

Weyde³

et al. 2012

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“…Our data support the previously published high response rates of EMS in pilot studies and patients with symptomatic diabetic and uremic neuropathy [1,7] and further define the duration of treatment effects as well as specific symptoms that can be treated efficiently. The mean duration of the treatment effect was limited to 31 hours and varied strongly between participants.…”

Section: Discussionsupporting

confidence: 89%

External Electric Muscle Stimulation Improves Burning Sensations and Sleeping Disturbances in Patients with Type 2 Diabetes and Symptomatic Neuropathy

Humpert¹,

Morcos²,

Oikonomou³

et al. 2009

Pain Med

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“…Previous studies analyzing glucose, HDL, LDL, T-Cho, and TG did not detect any significant changes in their levels following intradialytic EMS (19). Other studies showed that intradialytic highfrequency muscle stimulation increases levels of albumin with no significant changes in CRP and HbA1c levels in patients on maintenance HD (43), and led to a faster normalization of lowered nitrate/nitrite and elevated asymmetric dimethylarginine and endothelin in patients with acute kidney injury (44). There is inadequate information regarding the influence of intradialytic EMS on other biochemical parameters.…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effect of Intradialytic Electrical Muscle Stimulation in Hemodialysis Patients: A Randomized Controlled Trial

et al. 2018

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Many hemodialysis (HD) patients cannot perform self-administered exercise training for their muscle wasting, weakness, and sarcopenia. Electrical muscle stimulation (EMS) has the advantages of easy application, and minimal risks for these patients. This study aimed to evaluate the effects of intradialytic EMS. This was a prospective, open-label, randomized controlled trial. Twenty-nine HD patients were randomly assigned to either the EMS group or the control (no training) group, and 13 patients in each group were eventually analyzed. The EMS group received intradialytic EMS over an 8-week period. Measurement of isometric knee extensor strength using a handheld dynamometer, evaluation of the quadriceps cross-sectional area (CSA) using magnetic resonance imaging (MRI), the Timed Up & Go Test (TUG) for physical function assessment, the Japanese version of the Short Form-8 Health Survey (SF-8), and blood tests were performed before and after the intervention period. The primary and secondary outcomes were improvement of quadriceps muscle strength and size, respectively. The EMS group demonstrated significant improvement compared with the control group in terms of knee extensor strength (right: 22.3 ± 12.8 vs. -10.8 ± 22.3 N, P < 0.001; left: 26.1 ± 29.7 vs. -8.3 ± 18.7 N, P < 0.001), quadriceps CSA at three positions, 25, 50, and 75% of the segment length from the greater trochanter to the inferior border of the lateral epicondyle of the femur (25% right: EMS group 1.7 ± 2.0 vs. Control group -0.4 ± 1.8cm , P = 0.05; 25% left: EMS group 1.3 ± 1.1 vs. Control group -0.6 ± 1.8cm , P = 0.01; 50% right: EMS group 2.0 ± 2.2 vs. Control group -0.7 ± 1.9cm , P = 0.004; 50% left: EMS group 2.7 ± 2.1 vs. Control group -0.7 ± 1.6cm , P = 0.001; 75% right: EMS group 1.8 ± 2.2 vs. Control group -0.7 ± 1.5cm , P = 0.003; 75% left: EMS group 2.1 ± 1.9 vs. Control group -0.4 ± 1.5cm , P = 0.003); and TUG time (-0.8 ± 0.6 vs. 0.2 ± 0.5s, P < 0.001). The EMS group showed improvement after intervention in all components of SF-8, but these were not statistically significant. EMS could be an effective exercise training tool for HD patients with either muscle wasting, weakness, or sarcopenia.

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High-Tone External Muscle Stimulation in End-Stage Renal Disease: Effects on Symptomatic Diabetic and Uremic Peripheral Neuropathy

Cited by 24 publications

References 24 publications

The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

The effect of high-tone external muscle stimulation on symptoms and electrophysiological parameters of uremic peripheral neuropathy

External Electric Muscle Stimulation Improves Burning Sensations and Sleeping Disturbances in Patients with Type 2 Diabetes and Symptomatic Neuropathy

Beneficial Effect of Intradialytic Electrical Muscle Stimulation in Hemodialysis Patients: A Randomized Controlled Trial

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