Effect of exercise therapy on physical performance and functional balance in patients on maintenance renal hemodialysis: randomized controlled study

Abdelaal, Ashraf Abdelaal Mohamed; Abdulaziz, Ehab Mohamed

doi:10.12965/jer.1938176.088

Cited by 9 publications

(4 citation statements)

References 54 publications

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“…Similarly, Torres et al [ 37 ] and Frih et al [ 38 ] by applying a similar aerobic exercise program in HD patients, noted a significant improvement in 6-MWT distance by 6.5% and 15.9%, respectively. Furthermore, Abdelaal and Abdulaziz [ 39 ] investigated the effect of a 3-month intradialytic cycling program and a 3-month resistance training program with a 2-month post-study cessation. They found that after the end of the study, the aerobic group had a 33.1% increase in the distance in 6-MWT, while the resistance training group increased performance in 6-MWT by 22.5%.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Michou

Davioti

Syrakou

et al. 2023

JFMK

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Chronic kidney disease (CKD) leads to gradual muscle mass loss, which is strongly associated with lower functional capacity, which limits a patient’s daily activities. The aim of the present study is to examine the effects of a 4-month intradialytic exercise program on the functional capacity and body composition of kidney transplant (KT) candidates. Twenty-nine male patients on hemodialysis (HD) waiting for a kidney transplant, with a mean age of 53.86 ± 9.56 years old and BMI 27.11 ± 5.55 kg/m2, were randomly assigned into the following two groups: A (nA = 15 HD patients), who followed a 4-month intradialytic exercise program combining aerobic and resistance training, with a supervised, progressively increasing workload, and B (nB = 14 HD patients), who continued to receive usual care. At baseline and the end of the study, the KT candidates underwent a 6-min walking distance (6-MWD), and a 10-repetition sit-to-stand test (10-STS) to access physical function, a handgrip strength (HGS) test to evaluate the muscle strength of the non-fistula hand. Moreover, the bioelectrical impedance analysis (BIA) was performed to assess body composition indices, such as body fat (BF), body fat mass index (BFMI), fat-free mass index (FFMI), body cell mass (BCM), basal metabolic rate (BMR), extracellular water (ECW), intracellular water (ICW), total body water (TBW) and phase angle (PhA). Following the exercise program, group A showed favorable improvements in HGS (from 26.59 ± 9.23 to 28.61 ± 9.58 kg, p < 0.05) and 6-MWD (from 427.07 ± 7.66 to 468.16 ± 11.39 m, p < 0.05). Intergroup results from 6-MWD showed a statistically significant difference (Δp = 0.04), at the end of the study. Moreover, group A results from BIA revealed a significant increase of BMR by 2.4% (p < 0.05), ECW by 3.6% (p = 0.01), ICW by 3.8% (p = 0.01), TBW by 4.1% (p = 0.01), lean mass by 2.7% (p = 0.01), and PhA by 13.3% (p = 0.04), while a reduction in BF by 5.0% (p = 0.01) and BFMI by 6.6% (p = 0.03) was also noticed. At the end of the study, group A showed statistical differences in BMR (Δp = 0.01), BMR/BW (Δp = 0.01), dry lean (Δp = 0.01), and PhA (Δp = 0.03), compared to the group B. Linear regression analysis in group A after training showed positive correlations between HGS and both PhA (r = 0.52, p = 0.04) and FFMI (r = 0.64, p = 0.01), and a strong negative correlation between 6-MWT and BF (r = −0.61, p = 0.01). In conclusion, a 4-month intradialytic exercise program can enhance body composition and some physical parameters in HD patients awaiting kidney transplantation.

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Section: Discussionmentioning

confidence: 99%

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Michou

Davioti

Syrakou

et al. 2023

JFMK

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“…There are a few studies prescribing resistance training only, but many advocate a combination of endurance and resistance training using machines, weights or therabands. Balance in combination with aerobic training has been shown to be equally effective as a combination of resistance and aerobic training [ 17 , 46 ]. Complemetary and alternative exercise for enhancing physical well-being has also been successfully employed in patients on HD.…”

Section: Type Of Exercisementioning

confidence: 99%

Exercise training in chronic kidney disease—effects, expectations and adherence

Clyne

Anding-Rost

2021

Clinical Kidney Journal

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There is increasing evidence showing the health benefits of physical activity, such as better survival and possibly even a slower decline in kidney function, in people with chronic kidney disease (CKD). There is convincing evidence that exercise training improves physical function measured as aerobic capacity, muscle endurance strength and balance at all ages and all stages of CKD. In fact, long-term adherence to well-designed and adequately monitored exercise training programmes is high. In general, patients express interest in exercise training and are motivated to improve their physical function and health. A growing number of nephrologists regard physical activity and exercise training as beneficial to patients with CKD. However, many feel that they do not have the knowledge to prescribe exercise training and suppose that patients are not interested. Patients state that support from healthcare professionals is crucial to motivate them to participate in exercise training programmes and overcome medical, physical and psychological barriers such as frailty, fatigue, anxiety and fear. Equally important is the provision of funding by healthcare providers to ensure adequate prescription and follow-up by trained exercise physiologists for this important non-pharmacological treatment.

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“…Below are the main results of these studies. Abdelaal and Abdulaziz [ 50 ] found that both aerobic exercise training and resistance exercise training had favourable effects, with aerobic exercise having higher short- and long-term favourable effects on the physical performance and functional balance than resistance training in 60 patients on maintenance HD. Similar conclusions were found by Orcy et al [ 51 ] when comparing the effects of combined resistance and aerobic exercise with a resistance program alone on functional performance among HD patients.…”

Section: Effects Of Exercise On Skeletal Muscle Mass and Functionmentioning

confidence: 99%

Exercise training in dialysis patients: impact on cardiovascular and skeletal muscle health

Deligiannis

Cupisti

2021

Clinical Kidney Journal

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Dialysis patients show a high rate of reduced functional capacity, morbidity and mortality. Cardiovascular disorders, muscle atrophy and malnutrition, play an essential role among the etiological factors. Sedentary life characterizes them and contributes to the aggravation of these disorders. On the contrary, exercise training is an important preventive and therapeutic tool both for cardiovascular problems and for the appearance of muscle atrophy in dialysis patients. Regular exercise causes both central (cardiac) and peripheral (muscular) adaptations, improving functional capacity. In particular, in the circulatory system.clinical trials in hemodialysis patients documented that exercise has favorable effects on heart function, promotes the balance on the cardiac autonomic nervous system and contribute into the management of arterial hypertension. In the muscular system, it prevents muscle atrophy or contributes significantly to its treatment. The main preventive mechanisms of the beneficial effect of exercise on the muscles constitute the inhibition of the apoptotic processes and protein degradation. Exercise training in hemodialysis patients leads to an increase of muscle fibers, mitochondria and capillaries, and the combination of regular exercise and dietary strategies is even more effective in preventing or treating muscle atrophy. Finally, an improvement in functional capacity and quality of life was found also in peritoneal dialysis patients following exercise training.

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Effect of exercise therapy on physical performance and functional balance in patients on maintenance renal hemodialysis: randomized controlled study

Cited by 9 publications

References 54 publications

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Effects of a Combined Intradialytic Exercise Training Program on Functional Capacity and Body Composition in Kidney Transplant Candidates

Exercise training in chronic kidney disease—effects, expectations and adherence

Exercise training in dialysis patients: impact on cardiovascular and skeletal muscle health

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