Combined training is the most effective training modality to improve aerobic capacity and blood pressure control in people requiring haemodialysis for end-stage renal disease: systematic review and network meta-analysis

Scapini, Kátia Bilhar; Böhlke, Maristela; Moraes, Oscar Albuquerque de; Rodrigues, Clarissa Garcia; Inácio, José Francisco Secorun; Sbruzzi, Graciele; Leguisamo, Camila Pereira; Sanches, Íris Callado; Filho, Hugo Tourinho; Irigoyen, Maria Cláudia

doi:10.1016/j.jphys.2018.11.008

Cited by 50 publications

(50 citation statements)

References 53 publications

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“…Our meta-analysis found that exercise increased maximal oxygen consumption compared to the control, and the sub-group analysis revealed beneficial effects for both the aerobic and combined training modalities. These findings match those of a recent meta-analysis [16], which showed that both aerobic and combined training significantly improved VO 2max . In our analysis, combined training had a larger effect than aerobic training, which may be due to an increase in basal metabolism [65].…”

Section: Discussionsupporting

confidence: 90%

“…Exercise is also crucial for retaining physical independence [14]. Some of the important benefits linked to exercise include an improvement in physical fitness [15], aerobic capacity [16], dialysis adequacy (measured as urea Kt/V) [12], quality of life [17], and reduced depressive symptoms [18]. Exercise training can be delivered over different timings and modalities.…”

Section: Introductionmentioning

confidence: 99%

“…A recent meta-analysis [16] shed light on the effects of different exercise modalities. The authors stated that combined training is the most effective modality for increasing maximal oxygen consumption.…”

Section: Introductionmentioning

confidence: 99%

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Exercise-Based Interventions in Hemodialysis Patients: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials

Bogataj

Pajek

et al. 2019

JCM

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There is a lack of agreement on the efficacy of different exercise interventions in hemodialysis patients. We analyzed which exercise type is the most beneficial in terms of functional fitness and inflammation. A literature search of seven databases yielded 33 studies that met the inclusion criteria. Compared with an inactive control, the intervention group showed moderate effects (ES = 0.74; 95% CI 0.35 to 1.14; p < 0.001; and ES = 0.70; 95% CI 0.39 to 1.01; p < 0.001; respectively) on functional capacity (six-minute walk test) and oxygen consumption. Small nonsignificant effects were observed for aerobic (ES = −0.36; 95% CI −0.85 to 0.13; p = 0.154) and resistance (ES = −0.44; 95% CI −1.07 to 0.19; p = 0.169) training types, whereas moderate effects were found for combined (ES = −0.69; 95% CI −1.47 to 0.10; p = 0.088) training type based on a 10-repetition sit-to-stand test. Further, large and small effects were observed for aerobic (ES = −1.21; 95% CI −1.94 to −0.49; p = 0.001) and resistance training (ES = −0.54; 95% CI −0.90 to −0.17; p = 0.004) types on C-reactive protein. Overall, the results showed the numerically largest effect sizes for combined types compared to solely aerobic or resistance training types, with the differences between training types not reaching statistical significance. There was a significant modifying impact of age, training frequency, and session duration on performance and inflammatory outcomes.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Exercise-Based Interventions in Hemodialysis Patients: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials

Bogataj

Pajek

et al. 2019

JCM

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“…Although there are few studies of exercise and volume, 174 combined aerobic and resistance training has been associated with SBP and diastolic BP reductions. 175 Although many dialysis patients want to exercise, 176 barriers to exercise of any type include fatigue, dialysis access, time constraints, comorbidities, fear, and (for intradialytic exercise) clinic personnel workload. 177,178…”

Section: Exercise For Bp and Volume Controlmentioning

confidence: 99%

Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Flythe¹,

Chang²,

Gallagher³

et al. 2020

Kidney International

175

163

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“…In previous systematic reviews, the beneficial effects of exercise on the physical health of patients undergoing HD [ 33 , 34 , 35 , 36 , 37 , 38 ] as well as on the QoL were illuminated [ 39 , 40 , 41 , 42 , 43 , 44 , 45 ]. In two studies by Lu et al [ 46 ] and Molsted et al [ 47 ], the positive effects of exercise on muscle mass and muscle strength in patients undergoing HD were also stressed out.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review

et al. 2020

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Chronic kidney disease (CKD) is associated with aggravating factors which can affect both body composition and nutritional status. The purpose of the present systematic review was to investigate the potential effects of any physical activity on body composition or nutritional status among patients with stage 5 CKD undergoing hemodialysis (HD). A literature search on PubMed, Scopus, Web of Science, Google Scholar, and Cochrane was conducted and 14 randomized clinical trials were included. Skeletal muscle index and mid-arm muscular circumference increased after resistance exercise, and the results on body mass index, % body fat, and lean body mass varied. Serum albumin and C-reactive protein, in most cases, showed a slight increase and decrease, respectively. An improvement was also observed in body strength and overall performance status. The results suggest that physical activity can be beneficial for both the body composition and nutritional status of patients undergoing HD and can help in the prevention of sarcopenia. However, further research is needed mainly in the field of nutritional status.

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Combined training is the most effective training modality to improve aerobic capacity and blood pressure control in people requiring haemodialysis for end-stage renal disease: systematic review and network meta-analysis

Cited by 50 publications

References 53 publications

Exercise-Based Interventions in Hemodialysis Patients: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials

Exercise-Based Interventions in Hemodialysis Patients: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials

Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

The Effect of Exercise on Nutritional Status and Body Composition in Hemodialysis: A Systematic Review

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