A Program of Physical Rehabilitation during Hemodialysis Sessions Improves the Fitness of Dialysis Patients

Abstract

Aim: The aim of the present study was to evaluate the influence of cycle exercise during hemodialysis (HD) on patients’ physical proficiency, muscle strength, quality of life and selected laboratory parameters. Patients and Methods: In a group of 29 (15 female, 14 male) HD patients (age 64.2 ± 13.1 years), 3 months of cycle training during dialysis sessions was performed. The following data were analyzed: strength of lower extremities (six-minute walk test, isokinetic knee extension, flexion peak torque), nutrition parameters (albumin, BMI), inflammation intensity (CRP, IL-6), and quality of life (SF-36v2). Results: In the six-minute walk test, the increase in walk velocity was 4% (3.56 km/h before and 3.73 km/h after cycle training; p < 0.01). At angular velocity (AV) of 60°/s, extension peak torque in the knee joint rose by 7% and at AV of 300°/s by 4% (p = 0.04). Flexion peak torque at AV of 180°/s increased by 13% (p = 0.0005). The program does not influence nutrition or inflammation parameters. No complications directly related to exercise were observed. Conclusion: Cycle exercise during dialysis is safe even in older HD patients with multiple comorbidities. It results in a significant increase in general patient walking ability and in a gain in lower extremity muscle strength.

The Level of Anxiety and Depression in Dialysis Patients Undertaking Regular Physical Exercise Training - a Preliminary Study

“…The increase in quantity of muscle fibres, in particular type II A, increased activation of satellite cells, increased number of mitochondria and blood vessels have been proven [15][16][17][18].…”

“…Furthermore, it has a favourable effect on the increase in volume and ejection fraction of the heart, and on reduction in stiffness and resistance of blood vessels as well as on reduction in total and LDL cholesterol values. As a result, this is conducive to blood pressure normalization [15,16].…”

Self-Reported Physical Activity in Patients on Chronic Hemodialysis: Correlates and Barriers

“…There is evidence that L -carnitine [18,19,20,21,22,23], nandrolone decanoate [17] and growth hormone [24] supplementation may be useful. Some studies support the positive effects of regular physical activity on fatigue in patients on chronic hemodialysis [25,26,27]. …”

“…In other studies, physical inactivity has been shown to be associated with numerous clinical and laboratory variables such as insomnia, restless leg syndrome, depression [25], aging, diabetes and higher BMI [26], lower 25-OH vitamin D concentrations [27], parameters of malnutrition and/or chronic inflammation [28]. …”

Intra-Renal Hemodynamic Changes After Habitual Physical Activity in Patients with Chronic Kidney Disease

“…The patients usually cycle for 10-45 min and progressively resistance is applied to the bicycle wheels [72][73][74][75][76][77][78][79][80][81][82]. Also, resistance exercises have been applied in intradialytic exercise training programs without serious complications and induced beneficial effects on patient's muscular strength [83][84][85][86][87][88][89][90] The exercises sessions occurred at the hemodialysis centers during the first two hours of the hemodialysis treatment (table 4).…”