Effects of intradialytic exercise on functional capacity in patients with end-stage chronic kidney disease: a systematic review and meta-analysis

Araujo, Aline Machado; Orcy, Rafael Bueno; Feter, Natan; Weymar, Marina Krause; Cardoso, Rodrigo Kohn; Böhlke, Maristela; Rombaldi, Aírton José

doi:10.1080/15438627.2022.2079983

Cited by 6 publications

(3 citation statements)

References 58 publications

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“…47 This sentiment is echoed by other authors who report increased adherence to HIIT protocols compared with MICT. 17,31 Renal Disease An expanding body of evidence supports the use of exercise during hemodialysis for patients with end-stage renal disease due to many positive effects, including improved functional capacity 48,49 and dialysis efficacy. 50 Research regarding the use of HIIT for patients with endstage renal failure is emerging but is still in its infancy.…”

Section: Chronic Lung Diseasementioning

confidence: 99%

Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities

Brockway

Ayres

Shoemaker

2023

Cardiopulm Phys Ther J

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A rapidly growing body of research supports the use of high-intensity interval training across a wide range of health conditions encountered in physical therapy practice. However, most studies have included carefully selected patients without multimorbidity, significant activity limitations, or participation restrictions. In addition, much of the evidence address these patients in the outpatient setting which makes translating outcomes into clinical practice difficult for multimorbid patient populations across the continuum of care. Therefore, the present clinical perspective aims to synthesize and apply the evidence for the prescription of function-based high-intensity interval training (HIIT) programs to individuals with multiple, complex chronic diseases by (1) discussing the specific benefits of this type of exercise design for patients with multiple complex chronic health conditions; (2) highlighting the overlapping guidance for numerous conditions; (3) applying the evidence to designing individualized, functional HIIT programs to achieve functional improvement in addition to cardiorespiratory fitness; and (4) providing an example of functional HIIT program creation to demonstrate clinically relevant considerations. Clinical decision-making related to patient monitoring and safety is emphasized.

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Section: Chronic Lung Diseasementioning

confidence: 99%

Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities

Brockway

Ayres

Shoemaker

2023

Cardiopulm Phys Ther J

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“…Progression of chronic kidney disease (CKD) is strongly associated with severe complications, such as increased incidence of cardiovascular disease, hyperlipidemia, anemia, musculoskeletal disorders, fatigue, and cognitive impairment [ 1 , 2 ] Moreover, CKD patients experience multiple nutritional and catabolic alterations that are commonly referred to as protein–energy wasting (PEW) [ 3 ]. In addition, sarcopenia, decreased muscle strength, and functional deterioration are correlated with PEW in CKD patients [ 4 ]).…”

Section: Introductionmentioning

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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“…According to the latest report by the American College of Sports Medicine the popularity of aerobic training in the health sector among clinical populations (e.g., hemodialysis population) is growing in the last years (Kercher et al, 2023). Interestingly, aerobic intradialytic exercise (IDE) has been shown to be beneficial, among others, in improving physical and psychological dimensions of HRQoL, functional capacity, fatigue levels, blood pressure management and systemic inflammation (Araujo et al, 2022;Hu et al, 2022;Intiso, 2014;Meléndez Oliva et al, 2022;Pu et al, 2019). IDE is also considered as a promising strategy for a better blood pressure control during and 24 hours after HD treatment and is recognized to reduce hemodynamic instability as well as incidence and severity of IDH (Kim et al, 2019;Mcguire et al, 2018;Yildiz et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Acute effect of intradialytic aerobic exercise on hemodynamic response, dialysis-related side effects and proteome in patients with kidney failure: a pilot study.

Poirier¹,

Chénard²,

Tremblay³

et al. 2023

Preprint

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Effects of intradialytic exercise on functional capacity in patients with end-stage chronic kidney disease: a systematic review and meta-analysis

Cited by 6 publications

References 58 publications

Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities

Putting It All Together: An Evidence-Based Guide to High-Intensity Interval Exercise Prescription for Patients With Complex Comorbidities

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

Acute effect of intradialytic aerobic exercise on hemodynamic response, dialysis-related side effects and proteome in patients with kidney failure: a pilot study.

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