A 12-month lifestyle intervention does not improve cardiac autonomic function in patients with chronic kidney disease

Huppertz, Nina; Beetham, Kassia S.; Howden, Erin J.; Leicht, Anthony S.; Isbel, Nicole M.; Coombes, Jeff S.

doi:10.1016/j.autneu.2020.102642

Cited by 11 publications

(13 citation statements)

References 40 publications

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“…21 23 29-48 Two studies are secondary analyses. 45,47 Table 1 shows the design characteristics of the included studies. Chronic conditions included cancer (n=5), COPD (n=5), cardiac (n=4), diabetes (n=4), and CKD (n=4).…”

Section: Resultsmentioning

confidence: 99%

“…However, studies with aerobic exercise also indicated improvements in lower body strength and conditioning which may indicate that any level of muscle loading in patients with low physical condition is enough to elicit beneficial change. Other limitations included monitoring patient medication, 47 recruitment, 31 composite endpoints, 39 and rigorous exclusion/inclusion criteria. 38 Intervention design limitations included the under-reporting and lack of detail of the F.I.T.T.…”

Section: Discussionmentioning

confidence: 99%

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Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials

Billany

Vadaszy

Lightfoot

et al. 2020

Journal of Sports Sciences

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Skeletal muscle atrophy, dysfunction, and weakness are consequences of noncommunicable diseases which result in exercise and functional limitations which contribute to poor quality of life and increased mortality. Home-based resistance training may promote skeletal muscle health. MethodElectronic-based systematic searches were performed identifying randomised controlled trials utilising home-based resistance training in patients with noncommunicable diseases defined as cancer, cardiovascular disease, diabetes mellitus (type 1 and 2), chronic kidney disease (including dialysis), and chronic respiratory disease (asthma, chronic obstructive pulmonary disease, pulmonary hypertension). A comparator group was defined as one containing 'nonexercise' or 'usual care'. ResultsOf the 239 studies identified (published between 1996 and 2020), 22 met the inclusion criteria. Sixteen studies contained an adjunct aerobic training component. Study designs and outcome measures showed large variation. Reporting of the principles of training applied within interventions was poor. Conclusions Heterogeneity in study characteristics, and poor reporting of training characteristics, prevents formal recommendations for optimising home-based resistance training. However, homebased interventions are less resource-intensive than supervised programmes and appear to have the ability to improve or preserve pertinent outcomes such as strength, functional ability, and quality of life; potentially reducing the risk of mortality in patients with chronic disease.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials

Billany

Vadaszy

Lightfoot

et al. 2020

Journal of Sports Sciences

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“…It is possible that the level of exercise intensity may have different results on cardiac autonomic function. For example, high-intensity endurance training was more effective in improving parasympathetic activity compared to low-intensity endurance training in healthy individuals [ 45 ]. Low HRV is associated with an elevated risk of all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Combined Intradialytic Exercise Training Program and Music on Cardiac Autonomic Nervous System Activity in Hemodialysis Patients

Mitsiou

Dimitros

Roumeliotis

et al. 2022

Life

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This study aimed to examine the effect of an intradialytic exercise program in combination with music on heart rate variability (HRV) indices and functional capacity in patients on maintenance hemodialysis (HD). Methods: Forty HD patients were randomized to four training groups for six months: the combined music and exercise group (Group A), the exercise group (Group B), the music group (Group C), and the control group (Group D). At baseline and after 6 months, all participants underwent both short- (for 30 min) and long- (for 24 h) term measurements of HRV and functional capacity assessment with a 6 min walking test (6MWT). Patients of groups A and C listened to preferred music. Results: Long-term HRV analysis showed that standard deviation of all normal-to-normal RR intervals (SDNN) and the square root of the mean squared differences of successive RR intervals (rMSSD) were significantly higher at the end of the study in groups A (by 13.2% and 47.3%), B (by 15.1% and 50%), and C (by 9.0% and 30.1%), compared to group D (p < 0.05). Values of rMSSD and percentage of RR intervals differing by more than 50 ms from the preceding RR interval (pNN50) were elevated in groups A (by 35.6% and 142.9%), B (by 36.1% and 75%), and C (by 15.2% and 28.6%), compared to baseline measurements (p < 0.05). Also, pNN50 was increased in group A compared to groups B (by 21.4%), C (by 88.9%), and D (by 142.9%) (p < 0.05). Similar results were noted by short-term HRV analysis. Functional capacity was improved at the end of the 6-month study in groups A (by 20.3% and 25.7%) and B (by 15.8% and 21.1%) compared to groups C and D (p < 0.05). Conclusions: Intradialytic exercise combined with music-listening can improve the functional capacity and cardiac autonomic nervous system activity in hemodialysis patients.

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“…Numerous outcomes related to cardiovascular risk were analysed. Resting Systolic (SBP) (10 studies, 11 interventions groups, 440 participants) [20,23,24,26,27,32,35,40,44,45] and Diastolic (DBP) Blood Pressure (9 studies, 10 intervention groups, 408 participants) [20,23,24,26,30,32,35,40,45] did not change signi cantly (Supplemental Figures S8A & S8B). Subanalyses removing low-quality studies from pooled analyses continued to show no signi cance (Supplemental Figures S4A & S4B).…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

“…Sub-analysis of DBP by exercise modality showed a signi cant improvement for aerobic training (Supplemental Table S4). Resting Heart Rate (RHR) analysis (8 studies, 309 participants) [23,29,32,36,40,[44][45][46]] and sub-analyses showed no signi cance (Supplemental Figures S8C & S4C, Table S4). Endothelial function was assessed via Pulse Wave Velocity (PWV) (5 studies, 207 participants) [23,26,29,38,44] and the aortic Augmentation Index (AIx) (4 studies, 163 participants)[28, 29,38,44] with analysis and sub-analyses of both revealing no signi cant results (Supplemental Figures S8D & S8E, Table S4).…”

Section: Cardiovascular Risk Factorsmentioning

confidence: 99%

Clinical outcomes of exercise in people with pre-dialysis stages of chronic kidney disease: A systematic review with meta-analyses.

Traise¹,

Dieberg²,

Smart³

et al. 2022

Preprint

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Background Chronic kidney disease (CKD) is a leading cause of death and premature morbidity. Exercise may potentially delay or prevent disease progression. We conducted a systematic review and meta-analysis of the effect of exercise in people with pre-dialysis CKD on functional ability, quality of life, renal parameters, cardiovascular risk factors and inflammatory markers.Methods We searched 7 major databases from January 2000 to November 2021, using key terms related to pre-dialysis CKD and exercise. Trials comparing the effects of exercise with a control group were pooled. Meta-analyses used a random effects inverse variance model. Results Twenty-six trials (860 participants) met the inclusion criteria. Significant improvements were identified in peak VO2 (2.85mL/kg/min, 95%CI:1.31,4.40; p=0.0003); the 6 Minute Walk (54.25m, 95%CI:29.65,78.85; p<0.0001), Timed Up and Go (-0.34, 95%CI:-0.57,-0.12; p=0.003), 2 Minute Step (57.48 steps, 95%CI:27.80,87.16; p=0.0001), and Sit To Stand tests (6.45 repetitions, 95%CI:1.18,11.72; p=0.02)]; Short Form [SF]-36 General Health (5.27, 95%CI:0.25,10.28; p=0.04); SF-36 Physical Component Summary (1.91, 95%CI:0.25,3.57; p=0.02); SF-36 Mental Component Summary (2.40, 95%CI:0.37,4.42; p=0.02)]; and waist circumference (-3.17, 95%CI:-4.44,-1.89; p<0.00001).Conclusions Exercise improved aerobic capacity, functional ability and quality of life in people with early CKD. Additional evidence is needed to determine if progression towards dialysis can be delayed.

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A 12-month lifestyle intervention does not improve cardiac autonomic function in patients with chronic kidney disease

Cited by 11 publications

References 40 publications

Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials

Characteristics of effective home-based resistance training in patients with noncommunicable chronic diseases: a systematic scoping review of randomised controlled trials

Effects of a Combined Intradialytic Exercise Training Program and Music on Cardiac Autonomic Nervous System Activity in Hemodialysis Patients

Clinical outcomes of exercise in people with pre-dialysis stages of chronic kidney disease: A systematic review with meta-analyses.

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