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Feasibility and effects of intra-dialytic low-frequency electrical muscle stimulation and cycle training : a pilot randomized controlled trial
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McGregor, Gordon, Ennis, Stuart, Powell, Richard, Hamborg, Thomas, Raymond, Neil T., Owen, William, Aldridge, Nicolas, Evans, Gail, Goodby, Josie, Hewins, Sue, Banerjee, Prithwish, Krishnan, Nithya S., Ting, Stephen M. S. and Zehnder, Daniel (2018) Feasibility and effects of intra-dialytic low-frequency electrical muscle stimulation and cycle training : a pilot randomized controlled trial. PLoS One, 13 (7). e0200354. doi:10.1371/journal.pone.0200354 ISSN 1932-6203.
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Official URL: https://doi.org/10.1371/journal.pone.0200354
Abstract
Exercise capacity is reduced in chronic kidney failure (CKF). Intra-dialytic cycling is beneficial, but comorbidity and fatigue can prevent this type of training. Low-frequency electrical muscle stimulation (LF-EMS) of the quadriceps and hamstrings elicits a cardiovascular training stimulus and may be a suitable alternative. The main objectives of this trial were to assess the feasibility and efficacy of intra-dialytic LF-EMS vs. cycling.Assessor blind, parallel group, randomized controlled pilot study with sixty-four stable patients on maintenance hemodialysis. Participants were randomized to 10 weeks of 1) intra-dialytic cycling, 2) intra-dialytic LF-EMS, or 3) non-exercise control. Exercise was performed for up to one hour three times per week. Cycling workload was set at 40-60% oxygen uptake (VO2) reserve, and LF-EMS at maximum tolerable intensity. The control group did not complete any intra-dialytic exercise. Feasibility of intra-dialytic LF-EMS and cycling was the primary outcome, assessed by monitoring recruitment, retention and tolerability. At baseline and 10 weeks, secondary outcomes including cardio-respiratory reserve, muscle strength, and cardio-arterial structure and function were assessed.Fifty-one (of 64 randomized) participants completed the study (LF-EMS = 17 [77%], cycling = 16 [80%], control = 18 [82%]). Intra-dialytic LF-EMS and cycling were feasible and well tolerated (9% and 5% intolerance respectively, P = 0.9). At 10-weeks, cardio-respiratory reserve (VO2 peak) (Difference vs. control: LF-EMS +2.0 [95% CI, 0.3 to 3.7] ml.kg-1.min-1, P = 0.02, and cycling +3.0 [95% CI, 1.2 to 4.7] ml.kg-1.min-1, P = 0.001) and leg strength (Difference vs. control: LF-EMS, +94 [95% CI, 35.6 to 152.3] N, P = 0.002 and cycling, +65.1 [95% CI, 6.4 to 123.8] N, P = 0.002) were improved. Arterial structure and function were unaffected.Ten weeks of intra-dialytic LF-EMS or cycling improved cardio-respiratory reserve and muscular strength. For patients who are unable or unwilling to cycle during dialysis, LF-EMS is a feasible alternative.
Item Type: | Journal Article | ||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Library of Congress Subject Headings (LCSH): | Chronic renal failure, Quadriceps muscle, Hamstring muscle, Vasomotor conditioning, Cycling, Electric stimulation | ||||||
Journal or Publication Title: | PLoS One | ||||||
Publisher: | Public Library of Science | ||||||
ISSN: | 1932-6203 | ||||||
Official Date: | 11 July 2018 | ||||||
Dates: |
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Volume: | 13 | ||||||
Number: | 7 | ||||||
Article Number: | e0200354 | ||||||
DOI: | 10.1371/journal.pone.0200354 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 2 October 2018 | ||||||
Date of first compliant Open Access: | 2 October 2018 | ||||||
RIOXX Funder/Project Grant: |
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