Electroestimulación neuromuscular: una nueva opción terapéutica en la mejoría de la condición física de los pacientes en hemodiálisis

Abstract

Introduction: Haemodialysis patients are characterized by progressive muscle wasting and impaired physical condition. Recently, the neuromuscular electrostimulation is of great interest as adjunctive therapy of exercise in these patients. There are many studies that support the role of the electrostimulation in patients on haemodialysis. Objectives: To analyse the effect of a program of neuromuscular electrostimulation on muscle strength, functional capacity and quality of life in our patients on haemodialysis.
Methods: Prospective study of 12 weeks of duration. 22 patients were included. 62.8% male. Mean age of 67.8 years and 35.6 months of haemodialysis vintage. Mean Charlson index was 9. Main aetiologies of chronic renal failure: hypertension (13.6%), diabetes mellitus (27.3%), Glomerular (18.2%). Included patients performed an adaptive electrostimulation program in both quadriceps by the Compex® Theta 500i device. Most relevant analyzed data: 1. Muscular data: Maximum length quadriceps strength and “hand-grip. 2. Functional capacity tests: “Sit to stand to sit” and “six-minutes walking test”; 3. Symptoms in the lower extremities: Questionnaire of electrostimulation. 4. Level of satisfaction: Subjective Rating Scale and Visual Analogic Scale; 5. Quality of Life: EuroQoL-5D.
Results: At the end of the study, we observed a significant improvement (p<0.05) of the maximum length quadriceps strength* (10.2 ± 6.7 vs 13.1 ± 8.1 kg), Six minutes walking test* (9.5%, 290.5 vs. 312.4 m). In relation to the level of satisfaction by subjective rating scale, an improvement of 44% of the overall, 72% of the physical condition and 80% of the discomfort in the lower limbs, and the score on the questionnaire of electrostimulation* were observed. *(8.5 vs 5.8 sint/pat). The mean level of satisfaction was 7.8. Relative to the quality of life, we observed a significant improvement through the EuroQol5D* (52.7 vs 65.5%). No significant changes were observed in biochemical data or dialysis adequacy at study end.
Conclusions: The intra-dialytic neuromuscular electrostimulation of both quadriceps, improved muscle strength, functional capacity and quality of life of our patients on haemodialysis. With the results, neuromuscular electrostimulation is a new therapeutic alternative to improve fitness and quality of life of these patients.