Complication of Dialysis Clinical Trial
Official title:
Efficacy of Functional Electrical Stimulation Exercise Training in Hemodialysis Patients
Both strength training and endurance exercise training are commonly prescribed to improve strength and function in patients with physical limitations caused by chronic disease or disability including chronic kidney disease (CKD). Individuals with CKD often have low physical function due to progressive declines in the performance of their kidneys. The low physical function leads to physical inactivity, which exacerbates these functional declines and promotes cardiovascular disease and bone disorders. In addition, severe functional limitations in some patients prevent them from exercising at a great enough intensity to provide significant benefits. As a result, alternative strategies are needed to maximize the benefits of exercise while decreasing injury risk.
Both strength training and endurance exercise training are commonly prescribed to improve
strength and function in patients with physical limitations caused by chronic disease or
disability including chronic kidney disease (CKD). Individuals with CKD often have low
physical function due to progressive declines in the performance of their kidneys. The low
physical function leads to physical inactivity, which exacerbates these functional declines
and promotes cardiovascular disease and bone disorders. In addition, severe functional
limitations in some patients prevent them from exercising at a great enough intensity to
provide significant benefits. As a result, alternative strategies are needed to maximize the
benefits of exercise while decreasing injury risk.
A new form of exercise, functional electrical stimulation (FES)-enhanced cycling has been
shown to increase muscle size and strength in patients with severe disabilities, particularly
spinal cord injury (SCI). It is based on the application of electrical stimulation to the
nerves that innervate the paralyzed weak muscles in order to generate muscle contraction. FES
has been used to stimulate leg muscles to pedal a cycle or to enable partial weight-supported
walking as an activity based rehabilitation therapy. FES cycling involves exercising using a
motor-assisted cycle coupled with electrical stimulation to up to five muscles in the leg.
There are well-documented benefits of FES-induced exercise in SCI patients including
clinically significant increases in muscle mass, blood flow, bone density, and bowel and
bladder function. A few pilot studies have also demonstrated that FES therapy has the
potential to improve function in other disabled populations, including chronic heart failure
and stroke patients. However, its effects in other populations with significant physical
impairments, including CKD patients, have yet to be established.
The objective of the proposed research is to evaluate the effects of FES-cycling training on
measures related to physical function, quality of life (QOL), heart disease, and bone health
in patients with renal failure receiving dialysis therapy.
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