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Abstract: SA-PO055

Feasibility and Effectiveness of 6-Week Plantar Electrical Stimulation Therapy During Routine Hemodialysis Sessions to Improve Gait and Balance: A Randomized Controlled Trial

Session Information

Category: Bioengineering

  • 300 Bioengineering

Authors

  • Al-Ali, Fadwa M., Hamad Medical Corporation, Doha, Qatar
  • Zhou, He, Baylor College of Medicine, Houston, Texas, United States
  • Hamad, Abdullah Ibrahim, Hamad Medical Corporation, Doha, Qatar
  • Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Qatar
  • Mathew, Mincy M., Hamad Medical Corporation, Doha, Qatar
  • Ateya, Heba Mohamed, Hamad Medical Corporation, Doha, Qatar
  • Najafi, Bijan, Baylor College of Medicine, Houston, Texas, United States
Background

Poor gait and balance are serious problems for people with diabetes undergoing hemodialysis (HD). These patients visit their clinic three times weekly to receive HD which provides an optimal opportunity for intervention. This study aims to examine the feasibility and effectiveness of plantar electrical stimulation therapy (PEST) during routine HD sessions to improve gait and balance.

Methods

Twenty-six participants with diabetes receiving HD were recruited and randomized into an intervention group (IG: n=13, age=59.5±10.4years, BMI=29.7±6.0kg/m2, female=39%) or a control group (CG: n=13, age=63.2±6.1years, BMI=30.9±6.0kg/m2, female=54%). The IG received 1-hour PEST during routine HD process (3 sessions/week) for 12 weeks. The CG was provided with an identical but non-functional device for the same period. Participants were blinded to the group allocation. Gait and balance were examined at baseline, midline (6-week), and conclusion of the program. This study however focused on changes in gait and balance at 6-week.

Results

All participants in the IG tolerated the PEST and completed all sessions of the therapy indicating the feasibility. None of the gait or balance parameter showed noticeable differences in the CG group (p>0.050). However, improvement trends were observed in the IG with the largest effect observed in double support for gait parameters (13% improvement, Cohen’s effect size d=0.66) and eyes-open center of mass sway for balance parameters (27% improvement, d=0.31).

Conclusion

This pilot study provides earlier results on the feasibility and effectiveness of PEST during routine hemodialysis. The study is still ongoing and is expected to recruit 100 eligible participants for sufficient power. If results can hold in a larger sample size, it may recommend the use of routine plantar electrical stimulation therapy to improve mobility and potentially prevent falls in this highly vulnerable population, who are highly prevalent with frailty, depression, and falls caused by decline in motor function associated with hemodialysis.

Funding

  • Government Support - Non-U.S.