Effects of intradialytic cycling exercise on exercise capacity, quality of life, physical function and cardiovascular measures in adult haemodialysis patients: a systematic review and meta-analysis

Young, Hannah; March, Daniel S.; Graham-Brown, Matthew P M; Jones, Arwel W.; Curtis, Ffion; Grantham, Charlotte S.; Churchward, Darren R; Highton, Patrick J; Smith, Alice C.; Singh, Sally; Bridle, Christopher; Burton, James O.

doi:10.1093/ndt/gfy045

Cited by 93 publications

(83 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Once the full text of those articles was screened, 25 RCTs (1.8% of those identified by the search process) met all inclusion criteria . We also included five systematic reviews for our review of generic HRQOL …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The role of exercise in improving patient‐reported outcomes in individuals on dialysis: A scoping review

Bohm

Schick‐Makaroff

MacRae

et al. 2019

Seminars in Dialysis

View full text Add to dashboard Cite

Exercise improves objective measures of physical function in individuals on hemodialysis, but its effect on patient‐reported outcomes (PROs) is largely unknown. We performed a scoping review to characterize the existing knowledge base on exercise and PROs in dialysis patients to make recommendations for future research. We searched Medline, Embase, Cochrane Database of Systematic Reviews; Cochrane Central Register of Controlled Trials, CINAHL, and SPORT Discus from inception to November 28, 2018 and then screened results for randomized controlled trials comparing aerobic/resistance exercise, or both, with no exercise in individuals on dialysis that reported results of any PRO. Of 1374 eligible studies, 25 studies met inclusion criteria. Study interventions included aerobic exercise (11 intradialytic and 3 home‐based trials); intradialytic resistance exercise (seven studies) and combined aerobic and resistance exercise (six intradialytic and one facility‐based trial). The PROs measured included health‐related quality of life (n = 19), depression (n = 6), anxiety (n = 3), symptom burden (n = 4), sleep quality (n = 2), restless legs syndrome (n = 2), disability (n = 2), and self‐reported physical activity level (n = 4). Only five studies included a PRO as a primary outcome. Studies primarily used broad/generic measures of health‐related quality of life and the effect of exercise on symptoms remains relatively unexplored, particularly in peritoneal dialysis populations. Although limited, the role of exercise in improving restless legs was consistent and is a promising outcome for future study. A critical step to improving the quality of the research on this topic includes the use of validated and consistent PRO measures.

show abstract

Section: Resultsmentioning

confidence: 99%

“…The authors included two studies which used SF‐36 as a generic HRQOL measure and observed no significant difference in MCS and PCS score between exercise and usual care control groups. However, this meta‐analysis only included two studies with a total sample size of 52 and therefore interpretation is limited due to small sample size …”

Section: Resultsmentioning

confidence: 99%

The role of exercise in improving patient‐reported outcomes in individuals on dialysis: A scoping review

Bohm

Schick‐Makaroff

MacRae

et al. 2019

Seminars in Dialysis

View full text Add to dashboard Cite

show abstract

“…Whilst the above studies suggest exercise may improve LVEF in patients on hemodialysis, our systematic review and meta‐analysis suggested otherwise. An analysis that included only randomized controlled trials of patients undertaking intra‐dialytic cycling found no effect of exercise on LVEF . Again, though, this could be attributed to statistical power.…”

Section: Effects Of Exercise On Cardiovascular Structure and Functionmentioning

confidence: 97%

“…A 2014 systematic review by Sheng et al concluded that it is likely thatintra‐dialytic exercise programs have a positive effect on BP. Interestingly, a recent systematic review and meta‐analysis by our group that looked exclusively at randomized controlled trials of IDC found there is insufficient randomized controlled data to conclusively say whether programs of IDC improve BP control in hemodialysis patients . Safe to say, the data surrounding the effects of exercise on blood pressure are inconclusive.…”

Section: Effects Of Exercise On Blood Pressurementioning

confidence: 99%

“…8 our group that looked exclusively at randomized controlled trials of IDC found there is insufficient randomized controlled data to conclusively say whether programs of IDC improve BP control in hemodialysis patients. 42 Safe to say, the data surrounding the effects of exercise on blood pressure are inconclusive. This is partly because there is no "ideal" blood pressure for patients on dialysis, so it is difficult to know what constitutes an improvement on a population level.…”

Section: Future Researchmentioning

confidence: 99%

See 1 more Smart Citation

Cardiovascular adaptations associated with exercise in patients on hemodialysis

Graham-Brown

Jardine

Burton

2019

Seminars in Dialysis

View full text Add to dashboard Cite

Patients on hemodialysis are physically inactive. Less than 50% of hemodialysis patients undertake exercise once a week and such patients have increased mortality compared to patients who undertake regular exercise. The reasons for physical inactivity and reduced functional capacity are complex and inter‐related, with skeletal muscle catabolism, chronic inflammation, anemia, malnutrition, uremia, the burden of co‐morbid diseases, and “enforced” sedentary time during hemodialysis all contributing. Many of these factors drive cardiovascular disease (CVD) processes in this cohort of patients and in the general population, exercise interventions have been shown to modify many of these risk factors. Whilst there is increasing evidence about the beneficial effects of exercise interventions on quality of life, functional capacity, aerobic fitness, and muscular strength, there are few compelling data on the effects of such programs on cardiovascular outcome measures. The reasons for this are manifold and include: limitations in study size; inconsistencies in study design; the heterogeneous nature of exercise interventions; assessment of nonstandardized outcome measures and; a lack of understanding of what changes in certain traditional measures of CVD (such as blood pressure or lipid profile) mean for patients on hemodialysis. This review summarizes the current evidence base for the effects of exercise on traditional and nontraditional cardiovascular risk factors and the effects of exercise interventions on cardiovascular structure and function, including a review of study limitations and future research priorities.

show abstract

Exercise training for adults undergoing maintenance dialysis

Bernier-Jean

Beruni

Bondonno

et al. 2022

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

show abstract

Effects of intradialytic cycling exercise on exercise capacity, quality of life, physical function and cardiovascular measures in adult haemodialysis patients: a systematic review and meta-analysis

Abstract: There is insufficient evidence demonstrating whether cycling exercise during HD improves patient outcomes. High-quality, adequately powered RCTs of IDC are required.

Cited by 93 publications

References 57 publications

The role of exercise in improving patient‐reported outcomes in individuals on dialysis: A scoping review

The role of exercise in improving patient‐reported outcomes in individuals on dialysis: A scoping review

Cardiovascular adaptations associated with exercise in patients on hemodialysis

Exercise training for adults undergoing maintenance dialysis

Contact Info

Product

Resources

About