One of the etiology of limited functional capacity in chronic renal disease patient is muscle wasting. Increasing of Tumor Necrosis Factor Alpha (TNF-α) in chronic renal disease causes muscle wasting. Strengthening exercise is recommended by ACSM but it is hard to be done. Contraction of skeletal muscle will express interleukin-15 (IL-15) which is important for metabolism and skeletal muscle function. Isometric exercise and Neuromuscular electrical stimulation (NMES) are easy to be applied intradialytic and can fascilitate muscle contraction and has strengthening effect, but their effect in chronic kidney disease patient have not been largely reported yet. This study aimed to prove that intradialytic isometric exercise with or without NMES can modulate IL-15, TNF-α expression and improve functional capacity in chronic kidney disease patient.

Twenty-five chronic kidney disease patient underwent hemodialysis was randomly divided into 3 groups, control group, isometric group, and isometric and NMES group, received treatment twice a week, for 6 weeks. The subjects were examined for five times sit to stand test (FTSTS), IL-15 and TNF-α test by immunoassay before and after intervention.

There was increased of FTSTS in isometric group (P=0.007) and also combined isometric and NMES group (P=0.001). TNF-α in isometric group was increased (P=0.003) and also in combined isometric and NMES group (P=0.025). Compared to the control group, TNF-α was change significantly in isometric group (0.017) and also in combined isometric and NMES group (0.020). There was no significant difference in IL-15 levels pre-and post-experimental in all three groups (P>0.05).

Intradialytic isometric exercise with or without NMES for 6 weeks can improve functional capacity and also regulates TNF-α.