Effects of neuromuscular electrical stimulation (NMES) in patients undergoing haemodialysis: a systematic review and meta-analysis
In brief
Neuromuscular electrical stimulation raises handgrip strength by about 3 kg in dialysis patients
A meta-analysis of 11 small trials (346 patients) found NMES increased handgrip strength by roughly 3 kg, but the effect vanished when a single study was removed. No meaningful gains were seen in walking distance, sit-to-stand performance, lab markers, or quality-of-life domains, leaving its overall clinical value uncertain.
- Journal
- International urology and nephrology (Q2)
- Published
- 15 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Ahmed S Mohamed, Elle Fang, Elizabeth Church, Mazen Kafienah, Meena Rabi, Noorzia Ahmadi, et al.
- PMID
- 42742859
- DOI
- 10.1007/s11255-026-05357-0
Why clinicians should know about it
- Picked for Nephrology (top studies of the week, 20 September 2026).
Abstract
BACKGROUND: Neuromuscular electrical stimulation (NMES) uses surface electrodes to deliver electrical impulses that stimulate motor nerves causing muscle contractions. A potential use of NMES is for intradialytic rehabilitation strategy for patients undergoing maintenance haemodialysis (HD), but its effectiveness remains uncertain. This review analysis and meta-analysis evaluated whether the effects of NMES improve outcomes on physical performance, muscle strength, biochemical markers and Quality of Life (QoL) in patients undergoing long-term haemodialysis. METHODS: This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Randomised controlled trials (RCTs) were selected on PubMed, Scopus, Web of Science and Embase. Selected eligible studies were analysed for Quality of Life, functional capacity and physical performance, muscle strength, biochemical parameters and adverse effects. Results were expressed as mean differences (MD) or standardised mean differences (SMD) with a 95% confidence interval. RESULTS: 11 RCTs met the inclusion criteria, involving a total of 346 patients from 7 countries on long-term HD. NMES was associated with a significantly increased handgrip strength (pooled MD = 3.34 kg, 95% CI 0.95-5.73, P = 0.006); however, statistical significance was lost when one contributing trial was excluded in the leave-one-out analysis. There were no statistically significant benefits in pooled analysis of broader measures of physical performance including the six-minute walk test or sit-to-stand test, nor in biochemical markers or other SF-36 domains including mental health, vitality and social functioning. CONCLUSION: NMES may offer selective benefits in patients undergoing long-term haemodialysis such as improved handgrip strength; however, this was based on two small trials and was sensitive to the exclusion of one contributing study. No consistent benefits were observed across broader functional, biochemical or patient-reported outcomes. NMES may therefore represent a potential adjunct, but current evidence is insufficient to support replacing conventional intradialytic rehabilitation.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.