International urology and nephrology · 2026
Impact of neuromuscular electrical stimulation on physical performance, muscle strength, and body composition in hemodialysis patients: a meta-analysis of randomized and quasi-randomized controlled trials.
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Yu Youhui, Li Jie, Yuan Huaihong
Аннотация
PURPOSE: To evaluate the effects of neuromuscular electrical stimulation (NMES) on physical performance, muscle strength, and body composition in patients undergoing hemodialysis.
METHODS: Systematic searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library from their respective inceptions (earliest 1900) to March 31, 2026. Randomized and quasi-randomized controlled trials comparing NMES to usual care/sham NMES were eligible. Meta-analyses were performed for both post-intervention values and changes from baseline.
RESULTS: Seventeen trials (comprising 19 reports; n = 403) were included, with NMES treatment durations ranging from 4 to 20 weeks. NMES significantly improved 6-min walk test distance in both post-intervention (MD = 43.12 m; 95% CI 18.17, 68.07) and change from baseline (MD = 37.00 m; 95% CI 11.88, 62.12) analyses. Gait speed demonstrated a significant increase in the change value analysis (MD = 0.19 m/s; 95% CI 0.10, 0.28), although post-intervention comparisons were non-significant. No significant improvements were observed in skeletal muscle mass, lean body mass, handgrip strength, or adiposity markers. NMES was well-tolerated, with no adverse effects on dialysis adequacy (Kt/V, change MD = - 0.07, 95% CI - 0.16, 0.01), electrolyte balance (e.g. potassium, change SMD = 0.14; 95% CI - 0.25, 0.53), or hemodynamic stability (e.g., systolic blood pressure, change MD = - 1.58 mmHg; 95% CI - 10.72, 7.56).
CONCLUSION: NMES is a safe and effective rehabilitative tool for enhancing exercise tolerance and functional walking capacity in patients undergoing hemodialysis, despite limited impact on muscle hypertrophy or body composition.
METHODS: Systematic searches were conducted across PubMed, Embase, Web of Science, and the Cochrane Library from their respective inceptions (earliest 1900) to March 31, 2026. Randomized and quasi-randomized controlled trials comparing NMES to usual care/sham NMES were eligible. Meta-analyses were performed for both post-intervention values and changes from baseline.
RESULTS: Seventeen trials (comprising 19 reports; n = 403) were included, with NMES treatment durations ranging from 4 to 20 weeks. NMES significantly improved 6-min walk test distance in both post-intervention (MD = 43.12 m; 95% CI 18.17, 68.07) and change from baseline (MD = 37.00 m; 95% CI 11.88, 62.12) analyses. Gait speed demonstrated a significant increase in the change value analysis (MD = 0.19 m/s; 95% CI 0.10, 0.28), although post-intervention comparisons were non-significant. No significant improvements were observed in skeletal muscle mass, lean body mass, handgrip strength, or adiposity markers. NMES was well-tolerated, with no adverse effects on dialysis adequacy (Kt/V, change MD = - 0.07, 95% CI - 0.16, 0.01), electrolyte balance (e.g. potassium, change SMD = 0.14; 95% CI - 0.25, 0.53), or hemodynamic stability (e.g., systolic blood pressure, change MD = - 1.58 mmHg; 95% CI - 10.72, 7.56).
CONCLUSION: NMES is a safe and effective rehabilitative tool for enhancing exercise tolerance and functional walking capacity in patients undergoing hemodialysis, despite limited impact on muscle hypertrophy or body composition.