#935 Exploring the impact of sensory-feedback in foot on physical activity in frail hemodialysis patients: a randomized controlled trial

Abstract

Abstract Background and Aims Patients undergoing hemodialysis (HD) often face fatigue, time constraints, and impaired mobility, contributing to reduced physical activity and frailty. Intradialytic electrical stimulation (E-stim), particularly targeting the plantar region of the feet, is suggested as an alternative to traditional exercise programs. This study aims to investigate the association between sensory feedback in the foot and physical activity characteristics to demonstrate the efficacy of plantar electrical nerve stimulation (PENS) during HD in patients with frailty. Method 43 participants with pre-frail to frail levels based on the Fried frail criteria were enrolled. They were randomized to either an intervention group (IG: n = 21, age=55.5 ± 14.3 years, BMI = 28.5 ± 6.0 kg/m2, female = 28.6%, pre-frail=38.1%, frail=61.9%) receiving PENS or a control group (CG: n = 22, age = 61.0 ± 7.8 years, BMI = 30.7 ± 6.2 kg/m2, female = 45.5%, pre-frail = 36.4%, frail = 63.6%). The IG received 1-hour PENS during HD session (3 sessions/week), while CG received an identical but non-functional device for 12 weeks. The maximum Vibratory Perceptual Threshold (VPT) value was measured to assess sensory-feedback in foot, and daily life physical activity was assessed using the wearable pendant at the baseline and 12-weeks. The delta values (Δ) between 12-weeks and baseline were calculated to explore the association between VPT and physical activity. This study was supported by the Qatar National Research Foundation (QNRF, Award #NPRP10-0208-170400I). Results Age, gender, demographics, and other baseline characteristics were similar among IG and CG. 95% of participants completed 12 weeks regimen. In the IG, Δ walking duration (rho = −0.458, p = 0.037) and total step numbers (rho = 0.484, p = 0.026) were negatively correlated with Δ maximum VPT value, whereas there was no correlation in the CG. Conclusion Our study suggests that 12 weeks of E-stim therapy may enhance foot sensory feedback in the IG, potentially boosting walking-related activities in HD patients. Thus, we advocate for this practical therapy, especially for HD patients with frail symptoms, to promote increased physical activity.