Twelve-week intradialytic cycling exercise improves physical functional performance with gain in muscle strength and endurance: a randomized controlled trial

Abstract

Objective: To evaluate the effect of intradialytic cycling exercise on physical functional performance with gain in muscle strength and endurance in end-stage renal disease patients with haemodialysis. Design: Randomized controlled trial, with repeated measurements at baseline and after 4, 8, and 12 weeks of intradialytic cycling exercise. Setting: A 50-bed haemodialysis centre in a regional hospital in Taiwan. Subjects: Seventy-six regular haemodialysis patients, recruited and equally and randomly assigned to exercise and control groups. Intervention: The intradialytic cycling exercise was performed for 12 weeks and comprised warm-up, main, and cool-down exercise phases. A stationary cycling equipment was used, which involved aerobic and resistance modalities. The intensity was maintained at somewhat hard exertion. Each intradialytic cycling exercise was implemented for 30 minutes, starting at the second hour of treatment. Main measure: Measured outcomes were 6-minute walk distance, time taken to complete 10 sit-to-stand-to-sit cycles and number of sit-to-stand-to-sit cycles in 60 seconds. Results: Average (standard deviation) participant age was 55.47 (13.00) years. Therefore, the 6-minute walk distance was significantly different at weeks 8 ( P = 0.01) and 12 ( P < 0.001) in the exercise group compared with that in the control group at baseline. Notably, sit-to-stand-to-sit outcomes ( P = 0.01) significantly influenced the 6-minute walk distance. Sit-to-stand-to-sit outcomes significantly improved in the exercise group ( P < 0.05). Conclusion: Twelve-week intradialytic exercise for patients on haemodialysis can improve physical functional performance with gain muscle strength and endurance. This is a safe and effective method for improving health.

Reabilitação em pacientes com doença renal crônica em hemodiálise: Uma revisão sistemática de literatura

“…Sabe-se que a combinação de exercícios aeróbicos e resistidos, também denominada como programa de exercícios combinados, possui efeitos benéficos de forma global alterando aspectos cardiopulmonares e musculares de forma mais completa e abrangente (Paim et al, 2021). Portanto, sabendo que a capacidade funcional e a força muscular desses pacientes podem estar prejudicadas, Yeh et al (2020) buscaram analisar o efeito do ciclismo intradialítico no desempenho físico funcional com ganho de força e resistência muscular em pacientes com DRC avançada em hemodiálise. Foi realizado, neste caso, um programa de exercícios combinados através de um cicloergômetro que ofertava as duas modalidades de exercício por doze semanas, três vezes por semana, por trinta minutos, obtendo resultados significativos no aumento na distância percorrida do Teste de Caminhada de 6 minutos (TC6min), ou seja, uma melhora da capacidade submáxima e funcional de exercício e no Teste de Sentar e Levantar, que representa um aumento da força e resistência muscular de membros inferiores.…”

Therapeutic Effects of Intradialytic Exercise on Life Quality of Patients with End-Stage Renal Disease: Study Protocol for a Randomized Control Trial

“…Most intradialytic exercises in the literature, including the best-known CYCLE-HD study, were conducted for 30 min and given three times a week [ 11 , 13 , 14 , 15 , 16 ]. There is only one study that used the exercise frequency of two times a week, and the training mode involved resistance training and stretching, but not aerobic training [ 44 ].…”

“…The timings of the outcome measurements will be set according to past studies on intradialytic exercise. Some of them measured the results after 3 months of intradialytic exercise [ 13 , 14 , 15 ], while others were evaluated 6 months later [ 11 , 16 ].…”

“…In Taiwan, no HD unit incorporates an exercise program as part of regular care. Very few studies have evaluated the effects of structured intradialytic exercise programs on the level of physical activity and HRQoL of HD patients [ 13 , 14 , 15 ]. According to the ACSM’s guideline for an exercise prescription [ 10 ], the frequency of aerobic exercise for HD patients is 3 to 5 days per week.…”

Breathing-based leg exercises during hemodialysis improve quality of life: A randomized controlled trial

“…19,20 Notably, moderate-intensity aerobic and resistance exercises begin to show physical functional effects after eight weeks of practice. 6,12 This may be the exercise intervention effect was underestimated because of physiological influences. 6 The related physiological heart rate variability and fatigue were simultaneously considered in this study as evaluating the improvement of quality of life.…”