Impact and safety outcomes of an intradialytic physical exercise program

Yuguero-Ortiz, Anna; Gomez, Miquel; Arias‐Guillén, Marta; Ojeda, Raquel; Fontseré, Néstor; Rodas, Lida; Broseta, José Jesús; Vera, Manel; Hernández-Sánchez, Sonsoles; Maduell, Francisco

doi:10.1016/j.nefroe.2021.12.002

Cited by 5 publications

(10 citation statements)

References 27 publications

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“…These results indicate that exercise does not seem to augment the acute anabolic effects of intradialytic oral nutritional supplementation on nutritional status [ 57 ]. Similarly, Yuguero-Ortiz et al [ 21 ] showed that after a 6-month combined intradialytic exercise training twice a week, even though significant increases were noticed in 6-MWD, HGS, 10-STS, and BMI, PhA did not statistically change. Our results showed a significant increase in PhA and a positive correlation between HGS and PhA at the end of the study in our exercised KT recipients.…”

Section: Discussionmentioning

confidence: 90%

“…It is a fact that HD patients attend dialysis units three times per week and spend each session in a sitting position or lying on a bed for almost 4 h. Not surprisingly, several studies demonstrated that intradialytic exercise training is associated with higher adherence rates, compared to the one performed on the non-dialysis days [ 19 , 20 ]. The literatures results have shown remarkable improvements in 6-MWT and STS after long-term intradialytic exercise [ 21 , 22 , 23 ]. However, studies often come up with controversial results regarding body composition evaluation after an aerobic or resistance exercise training session.…”

Section: Introductionmentioning

confidence: 99%

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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: 90%

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

View full text Add to dashboard Cite

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“…Patients were submitted to intradialytic resistance training sessions under the supervision of experienced exercise physiologists and physiotherapists. The intervention was delivered twice a week due to budget conditions, and this weekly frequency was also previously reported (Anding et al, 2015; Yuguero‐Ortiz et al, 2021). The incremental resistance training protocol consisted of joint mobility exercises enclosing a warm‐up, three lower‐ and three upper‐limb resistance exercises and breathing exercises to cool down.…”

Section: Methodsmentioning

confidence: 94%

“…Patients were submitted to intradialytic resistance training sessions under the supervision of experienced exercise physiologists and physiotherapists. The intervention was delivered twice a week due to budget conditions, and this weekly frequency was also previously reported (Anding et al, 2015;Yuguero-Ortiz et al, 2021) Before the onset of the protocol, every patient was familiarized with the OMNI resistance exercise scale (OMNI-RES) to assess the RPE (Lagally & Robertson, 2006). OMNI-RES was recorded during exercise for monitoring and 30 min after the protocol (to avoid an overestimation due to physical tiredness) for estimating the session RPE (McGuigan & Foster, 2004).…”

Section: Intradialytic Resistance Training Protocolmentioning

confidence: 99%

Implementing a resistance training programme for patients on short daily haemodialysis: A feasibility study

Ribeiro

Cunha

Dourado

et al. 2022

Journal of Renal Care

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Background Kidney failure patients receiving haemodialysis experience protein‐energy wasting, muscle mass loss and physical function impairment. Intradialytic exercise interventions seem to modify these features, but they are often not implemented as a clinical routine. Objective To investigate the feasibility of implementing a supervised intradialytic resistance training programme as a clinical routine for patients receiving short daily haemodialysis. Design A prospective longitudinal study. Participants Eighteen patients in a supervised intradialytic resistance training programme for 8 months. Measurements It consisted of a warm‐up, lower‐ and upper‐limb resistance exercises and a cool‐down. Patients performed the resistance training during the first half of haemodialysis, twice a week, supervised by exercise physiologists and physiotherapists. The feasibility was assessed by the total and partial adherences, the reasons for refusing or for not exercising and the intradialytic complications. Results From a total of 953 potential exercise sessions, 759 were performed, with a 79.6% adherence rate. In the first 9 weeks, the adherence rate was 86.6% and the lowest rate was in the 19–27 weeks (73.5%). The main intradialytic complication during exercise sessions was hypotension (n = 31; 4.1%). The highest number of complications was reported during the first 9 weeks (n = 27; 9.1%). The main reasons for refusing or for not performing the intradialytic exercise sessions were clinical complications previous to exercise time (n = 63; 32.5%) and self‐reported indisposition (n = 62; 32.0%). Conclusions The intradialytic resistance training programme, supervised by exercise physiologists and physiotherapists, had very low complications, achieved a high long‐term adherence rate and showed to be feasible as a clinical routine for patients receiving short daily haemodialysis.

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“…Csuka and McCarty [ 62 ] first described the use of the STS test as a measure of lower-extremity strength (force-generating capacity of muscle). The literature results have shown remarkable improvements in STS after long-term intradialytic exercise [ 63 , 64 ]. In the experimental group, we found 1.5 s (6.1%) absolute mean improvement in the 10-STS time.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Intradialytic Cognitive and Physical Training Program on the Physical and Cognitive Abilities in End-Stage Kidney Disease Patients: A Randomized Clinical Controlled Trial

Kren,

Bogataj

2023

Brain Sciences

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Background: Hemodialysis (HD) patients have lower cognitive functioning and reduced physical fitness than age-matched healthy individuals. Clinicians typically do not recognize the declining cognitive performance in these patients; therefore, cognitive impairment is greatly underestimated and not appropriately treated. This study aimed to evaluate the impact on cognitive function of combining cognitive training with physical exercise and physical performance in HD patients. Methods: Using a randomized, single-blinded control design, forty-four HD patients were recruited and randomly assigned to either an intradialytic physical exercise and cognitive training program (EXP group; n = 22; 54% male; 65.7 ± 9.7 years; 77.1 ± 21.9 kg; body mass index 26.8 ± 6.0) or a standard care control group (CON group; n = 21; 77% male; 67.2 ± 12.5 years; 74.2 ± 14.3 kg; body mass index 25.9 ± 3.8). The EXP group performed intradialytic cycling and cognitive training three days per week for 12 weeks. Study outcomes were assessed by the Symbol Digit Modalities Test (SDMT), Montreal Cognitive Assessment (MoCA), 10-repetition sit-to-stand test (10-STS), handgrip strength test (HGS), and stork balance test. Results: The results showed a significant time*group interaction effect for SDMT (p < 0.001; η2 = 0.267) and MoCA (p < 0.001; η2 = 0.266). Moreover, no significant interaction was observed for 10-STS, HGS, and stork balance test (p > 0.05). Conclusions: Our findings suggest that incorporating intradialytic cognitive and physical exercise training could help to improve the functional status of HD patients. The innovative, nonpharmacological, bimodal intervention is cost-effective, safe, and easy to implement during the intradialytic period and offers a potential impact on patients’ quality of life and well-being.

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Impact and safety outcomes of an intradialytic physical exercise program

Cited by 5 publications

References 27 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

Implementing a resistance training programme for patients on short daily haemodialysis: A feasibility study

The Impact of Intradialytic Cognitive and Physical Training Program on the Physical and Cognitive Abilities in End-Stage Kidney Disease Patients: A Randomized Clinical Controlled Trial

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