Effects of intradialytic exercise for advanced-age patients undergoing hemodialysis: A randomized controlled trial

Abstract

Previous reports have shown the benefits of intradialytic exercise to patients undergoing hemodialysis. However, most of those studies assessed the effects of exercise in middle-aged patients and little is known about advanced-age patients undergoing hemodialysis. Therefore, the present randomized controlled trial was performed to determine the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. This non-blinded, randomized controlled parallel trial enrolled a total of 101 patients who were randomly assigned to intradialytic exercise (n = 51) or usual care (n = 50) groups. The training program included both resistance and aerobic exercises and was performed three times per week for 6 months. The aerobic exercise intensity was adjusted to a target Borg score of 13 for 20 minutes. Four types of resistance exercises were performed using elastic tubing, with three sets of 10 exercises performed at moderate intensity (13/20 on the Borg scale). The usual care group received standard care. Lower extremity muscle strength, Short Physical Performance Battery score, and 10-m walking speed were the outcomes and were evaluated before the hemodialysis session and after 6 months of training. There were statistically significant improvements in Short Physical Performance Battery score (effect size, 0.57; 95% confidence interval, 0.15‒1.95) in the exercise group relative to the control group. There were no statistically significant differences in lower extremity muscle strength or in the 10-m walking speed between the two groups. These findings suggest that 6 months of intradialytic training could improve physical function in older patients undergoing hemodialysis.

Age and sex differences in the effectiveness of intradialytic resistance training on muscle function

“…In the OO patients, the relatively frequent cardiovascular and metabolic comorbidities may have lowered their functional adaptability to IRT 45 , 46 . This partially aligns with some previous reports on CKD-5D patients that found beneficial effects of exercise on MF in patients aged above 60 and 65 years 33 , 47 , 48 and with reports of no improvements in lower extremity muscle strength after intradialytic exercise in patients aged above 70 and above 80 years 49 , 50 . However, other studies reported no age-differences in functional adaptation after intradialytic- and home-based exercise in CKD-5D patients 19 , 44 .…”

Does Intradialytic Group Exercise Programme Influence Patient-Reported Outcomes, Laboratory Parameters, and Anthropometric Parameters in Maintenance Hemodialysis Patients? A Single-Group Repeated-Measures Trial

“…In addition to death, hospital transfer, hospitalization, surgery and other irresistible factors, 7 patients (7.7%) dropped out of the study due to loss of motivation, the proportion is lower than in previous studies. 38 , 39 During the first data collection, 2 patients were unwilling to continue the study because data collection occupied too much of their time. During the intervention, 5 patients lost motivation and dropped out of the study.…”

Age‐associated effects of intradialytic exercise on physical function and nutritional status in patients receiving ambulatory hemodialysis: A multicenter cohort study

“…However, the degree of improved physical function and nutritional status through exercise therapy and the factors associated with this improvement remain unclear. Some previous reports on intradialytic exercise have indicated a positive effect on exercise tolerance, gait function, and muscle strength, 7,8 while other studies have reported failure in improving physical function 9,10 . These studies that demonstrated difficulty in improving physical function despite exercise suggest that certain factors might affect the improvement in physical function and nutritional status.…”