Twelve-week changes in physical function among older hemodialysis patients receiving intradialytic electrical muscle stimulation or resistance training: a multicenter exploratory comparative observational study.

Authors

Ren Takahashi, Hiroki Yabe, Haruka Nakano, Yoshina Takigiku, Ayuna Matsui, Takashi Hibino, Hideaki Ishikawa, Yoshifumi Moriyama, Tetsuya Yamada

Published in

Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation. Nov 10, 2026. Epub Nov 10, 2026.

Abstract

To compare 12-week changes in lower-limb muscle strength and physical function among older patients receiving hemodialysis (HD) who received intradialytic electrical muscle stimulation (EMS), conventional resistance training (RT), or no intradialytic exercise.
In this multicenter, exploratory, comparative observational study, outpatients aged ≥65 years receiving maintenance HD were identified from facility databases: EMS or RT patients in 2025 and controls in 2019-2024. EMS and RT were performed three times per week during HD for 12 weeks. Isometric knee extension strength (IKES), 10-m walking speed (10MWS), and the Short Physical Performance Battery (SPPB) were assessed at baseline and 12 weeks. Changes were analyzed using linear mixed-effects models with effect sizes (ES).
A total of 81 patients were analyzed (RT, n = 36; EMS, n = 22; control, n = 23). The group-by-time interaction was significant for IKES (p = 0.0046). Compared with controls, differences in IKES change were 5.88 percentage points for RT (95% CI, 1.56-10.19; p = 0.008; ES = 1.17) and 7.57 for EMS (95% CI, 2.96-12.18; p = 0.002; ES = 1.50). The RT-versus-EMS difference was -1.69 percentage points (95% CI, -5.76 to 2.37; p = 0.408; ES = -0.34). No statistically significant between-group differences in changes were detected for 10MWS or SPPB.
In older HD patients, 12-week intradialytic EMS was associated with increased lower-limb muscle strength compared with controls. No significant difference was detected between EMS and RT. These exploratory findings support further evaluation of intradialytic EMS.

PMID:
43009109
Bibliographic data and abstract were imported from PubMed on 11 Nov 2026.

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