Far infrared stimulation of neiguan acupoints improves heart rate variability and ameliorate fatigue in hemodialysis patients: A randomized trial

Background: In 2018, 84,615 patients in Taiwan received hemodialysis, of which about 62% - 97% suffered from fatigue. Fatigue caused by hemodialysis may be mental or physical. However, the detailed mechanism remains unclear. This study aimed to evaluate whether far-infrared stimulation of the neiguan acupoint (P6) could effectively reduce fatigue and improve heart rate variability (HRV) in hemodialysis patients. Methods: We conducted a two-arm, randomized trial in a hemodialysis center between Mar 2015 and Mar 2016. A total of 73 hemodialysis patients were included and were randomly assigned to an experimental group ( n =37) and a control group ( n =36). The experimental group received far-infrared radiation on neiguan acupoint during hemodialysis for 12 weeks. The outcomes were fatigue level and HRV. Results: All patients showed moderate fatigue ( M =26.00 ± 13.01, range =0~78) at baseline. Far-infrared stimulation on neiguan acupoint significantly reduced overall fatigue ( β =24, p <0.001) and improved HRV ( β =74.36, p <0.001). Compared to the control group, the experiment group had significantly reduced fatigue levels in all aspects such as reduced energy and motivation ( β =-2.97, p <0.001), reduced physical strength ( β =-1.28, p <0.01), reduced mental capability ( β =-2.38, p <0.001), reduction in daily activities ( β =-1.48, p <0.01), depressed mood and loss of control ( β =-1.21, p <0.05) as well as increased autonomous nervous system activity ( β =14.71, p <0.01) in the third month of stimulation. Conclusion: Far-infrared stimulation of the neiguan acupoints effectively reduces fatigue and increases autonomic nervous system activity in hemodialysis patients.