Home-based Aerobic Exercise and Resistance Training in Peritoneal Dialysis Patients: A Randomized Controlled Trial

Abstract

Potential effects of aerobic and resistance training in peritoneal dialysis (PD) patients have been partially elucidated. We investigated effects of a home-based exercise program on physical functioning and health-related quality of life (HRQOL) in PD patients. Patients were randomly assigned to exercise (n = 24) and usual care (n = 23) groups. The exercise patients performed aerobic exercise thrice weekly and resistance training twice weekly at home for 12 weeks. The usual care patients received no specific intervention. The distance in incremental shuttle walking test significantly improved in the exercise group compared with the usual care group ( P = 0.02). Among the HRQOL subscales assessed using the Kidney Disease Quality of Life-Short Form questionnaire, kidney disease component summary ( P = 0.03), physical role functioning ( P = 0.01), emotional role functioning ( P < 0.01), and role/social component summary ( P < 0.01) significantly improved in the exercise group. Moreover, serum albumin was significantly maintained in the exercise group ( P = 0.03). There were no reported adverse events associated with the intervention. To our knowledge, this is the first randomized controlled trial to indicate the beneficial effects of a 12-week home-based exercise program exclusively in PD patients.

Exercise and physical activity for people receiving peritoneal dialysis: Why not?

“…Although there have been infrequent case reports hypothesizing the association of exercise, leaks, hernia, or catheter malfunction, there are no reports of serious adverse events associated with exercise in the most recent exercise and PD meta‐analysis . In these exercise interventional studies, aerobic exercise and combined resistance/aerobic exercise programs were well tolerated with no reported serious adverse events. This included no adverse events during a 3‐month Wu‐style Tai Chi program that included bi‐weekly hour‐long sessions with a certified trainer…”

The Impact of Home-Based Exercise Program on Physical Function of Chronic Kidney Disease Patients: A Meta-Analysis of Randomized Controlled Trials

“…Four studies were removed because of the study design [22][23][24][25]. Ultimately, five RCTs were included in the meta-analysis [16,17,[26][27][28][29][30].…”

“…There were similar age, male, and body mass index between exercise group and control group at baseline. Four RCTs involved the dialysis patients [16,17,26,28,29], and the remaining RCT involved patients not requiring dialysis [27,30].…”

“…Among the seven RCTs, two studies reported 6-min walk test [16,30], three studies reported grip strength change [17,27,29], three studies reported pain scores [16,17,26], and three studies reported symptom/problem list, effects of kidney disease, and burden of kidney disease [26,28,29]. Jadad scores of the seven included studies varied from 3 to 5, and all seven studies were considered to have high-quality.…”

Characteristics of effective home-based resistance training exercise in patients with chronic disease: a scoping review protocol

“…Large homogeneity in other home-based resistance training protocols have been observed in patients with COPD 35 , diabetes 36 , and kidney disease. 37 A key explanation for this is likely the lack of progression and intensity achievable in a home-setting, and whilst manipulating set and repetition quantities outside conventional ranges may mitigate this 32 , further research in optimising home-based resistance exercise is needed.…”