The effects of intradialytic resistance training on muscle strength, psychological well-being, clinical outcomes and circulatory micro-ribonucleic acid profiles in haemodialysis patients

Abstract

Background: Intradialytic resistance training (IRT) protects patients’ muscle mass and functions against protein-energy wasting, malnutrition and cachexia. However, the evidence of the effects of such an intervention in haemodialysis patients is limited and not conclusive. To improve the applicability of such interventions, we need a better understanding of molecular, functional and psycho-social adaptation in dialysed patients following a physical training. Therefore, the aim of this study is to investigate the effects of IRT on lower extremity muscle functions, quality of life, and anxiety and depression, clinical outcomes and circulatory micro-ribonucleic acid (miRNA) profiles in patients on chronic haemodialysis therapy. Methods: We will perform a quasi-experimental study in 3 dialysis centres. Patients will be recruited via their nephrologists and will be allocated to an experimental and a control group based on the location of the patients’ dialysis centre. Patients allocated to the experimental group will undergo a 12-week IRT, while the control group will remain physically inactive during dialysis. The primary outcome is the change in the maximal force produced during an isometric contraction of lower extremity muscles. Secondary outcomes regard quality of life, anxiety and depression, clinical outcomes and circulatory miRNA profiles. Patients’ level of health literacy defined as the ability to get and understand health information will be also measured in the study as a potential modifier of effects. Discussion: This quasi-experimental study can add in an important way to our understanding of the effects of resistance training on dialysis patients’ muscle strength, quality of life and disease-specific outcomes.

Validation of the Functional Assessment of Anorexia/Cachexia Therapy Instrument to Assess Quality of Life in Maintenance Hemodialysis-Treated Patients with Cachexia

“…Quality of life should be evaluated from various aspects; thus, the presence of correlation is understandable. Cachexia can greatly affect the body function of hemodialysis-treated patients [22,23] . This result explains the relatively large correlation of PWB with ACS.…”

MicroRNA molecules as predictive biomarkers of adaptive responses to strength training and physical inactivity in haemodialysis patients

“…14N/2017) and registered at ClinicalTrials.gov (ID:NCT03511924). All methods, assessments and data acquisitions were conducted according to the relevant ethics guidelines and regulations, based on the Declaration of Helsinki (1975, as revised in 2013) and followed the study protocol 42 .…”

“…When the patient was able to perform five sets with 18 repetitions for each exercise, we made the IRT harder by applying a stiffer elastic band or an over-ball with higher hardness. If a patient failed to complete the entire training session, or had obvious difficulties, the IRT was facilitated by lowering the number of repetitions per set, or of sets, or by the application of softer elastic bands and over-balls 42 . This methodology of training progressivity enabled us to maintain the patient's safety during IRT and ensured the intensity of training to be between "moderate" and "hard".…”

The effects of an intradialytic resistance training on lower extremity muscle functions

“…14N/2017); the protocol was registered at ClinicalTrials.gov (ID: NCT03511924). All methods, assessments and data acquisitions were conducted according to relevant ethics guidelines and regulations, based on the Helsinki Declaration (Helsinki Declaration of 1975, as revised in 2013) and followed the official protocol of study [30].…”

“…We chose the primary outcome in this study based on those used in previous studies that were most sensitive to strength training during dialysis and based on feasibility in a multicenter design of our study. A detailed description of outcomes assessments is described in the protocol article [30]. Maximal isometric forces generated during three lower extremity movements (KE, HF, and hip extension (HE)) were assessed by a hand-held dynamometer (Universal digital force gauge HF 500, SAUTER GmbH, Balingen, Germany).…”