Kidney Week

Abstract: PO0773

Effectiveness of Intradialytic Plantar Electrical Nerve Stimulation During Hemodialysis to Improve the Gait in Adults with Diabetes and Renal Failure: A Randomized Double-Blinded Controlled Trial

Session Information

• Diabetic Kidney Disease: Clinical
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diabetic Kidney Disease

• 602 Diabetic Kidney Disease: Clinical

Authors

• Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Abdullah Ibrahim Hamad, MD, FASN

• Mishra, Ram kinker, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, Texas, United States

Ram kinker Mishra,

• Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Rania Abdelaziz Ibrahim,

• Mathew, Mincy, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mincy Mathew,

• Mohamed, Mohamed Yahya Abdelhai, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Mohamed Yahya Abdelhai Mohamed,

• Ateya, Heba Mohamed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Heba Mohamed Ateya,

• Khan, Saifatullah, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Saifatullah Khan,

• Talal, Talal, Diabetic Foot and Wound Clinic, Hamad Medical Corporation, Doha, Qatar, Qatar

Talal Talal,

• Najafi, Bijan, Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Houston, Texas, United States

Bijan Najafi,

• Al-Ali, Fadwa M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar

Fadwa M. Al-Ali,

Background

Impaired mobility is a persistent problem among patients undergoing hemodialysis (HD). Although exercise could be beneficial, factors such as post-dialysis fatigue, time limitation, and severe frailty to travel may result in poor adherence to conventional exercise programs. To address this gap, we are exploring an alternative therapy using intradialytic plantar electrical nerve stimulation (IPENS) provided during the routine hemodialysis process.

Methods

Participants were randomized into either an intervention group (IG: n=21, age=55±2.7 years, BMI=30.6±1.3 kg/m², female=31%) or a control group (CG: n=24, age=56±2.2 years, BMI=32.2±1.2 kg/m², female=41%). The IG received 1-hour IPENS during the routine HD process (3 sessions/week) for 12 weeks. The CG received an identical but non-functional device for the same period. Participants and therapy-providers were blinded to the group allocation. Gait performance was assessed under single-task (ST) and dual-task (DT) conditions at the baseline, 6 week, and 12-week under supervised condition. To determine the effect of intervention, we estimated Cohen’s effect size d. In addition, time effect, group, and time×group effects were estimated using general linear model.

Results

All participants in the IG tolerated the IPENS and completed all therapy sessions, indicating the feasibility. While, under DT condition, cadence (steps/min) and stride time (sec) increased significantly in both groups over the time, we observed a trend towards higher improvement in IG group (Cohen's d=0.54, p=0.086 for cadence and d=0.52, p=0.09 for stride time) with a medium effect size compared to CG. We observed significant time effect on other gait parameters under ST and DT conditions with the similar trends towards group effect.

Conclusion

This pilot trial provides earlier results on IPENS therapy's feasibility and effectiveness as an alternative to exercise programs to improve gait in HD patients. Even though, the improvement didn’t reach statistical significance in our current sample size. However, the effect size was medium, which is very promising.

Funding

• Government Support – Non-U.S.