Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial

Abstract

Purpose To investigate the effect of intradialytic resistance exercise on inflammation markers and sarcopenia indices in maintenance hemodialysis (MHD) patients with sarcopenia. Methods Forty-one MHD patients with sarcopenia were divided into an intervention group (group E, n = 21) and a control group (group C, n = 20). Group C patients only received routine hemodialysis care, whereas group E patients received progressive intradialytic resistance exercise with high or moderate intensity for 12 weeks at three times per week (using the weight of the lower limbs and elastic ball movement of the upper limb) on the basis of routine hemodialysis care. Results After 12 weeks, a significant difference in physical activity status (maximum grip strength, daily pace, and physical activity level), Kt/V, and C-reactive protein was found between groups E and C. Inflammatory factors (interleukin (IL)-6, IL-10, and tumor necrosis factor(TNF)-α) increased or decreased more significantly in group E than in group C. Conclusions This study showed that intradialytic resistance exercise can improve physical activity effectively and reduce microinflammatory reactions even if this simple exercise does not affect the muscle mass in MHD patients with sarcopenia.

Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…There was a statistically significant improvement in intervention groups (SMD = 3.55 (2.28–4.83); p < 0.001; I 2 = 90%) ( Figure 3 ). Grip strength was reported in 19 RT studies [ 44 , 45 , 49 , 52 , 53 , 55 , 56 , 59 , 61 , 65 , 67 , 69 , 70 , 74 , 75 , 76 , 77 , 78 , 79 ]. There was a mean increase of 1.48 kg (0.26–2–23 kg; p < 0.001) across studies with pre-post mean differences ranging from −1.00 to 5.70 kg.…”

“…Muscle mass was reported in 7 RT studies (8 intervention groups) [ 45 , 52 , 70 , 71 , 74 , 78 , 80 ]. Compared to control groups, there was not a statistically significant increase in muscles mass in intervention groups across studies (MD = 0.60 kg (−0.18–1.37 kg); p = 0.13; I 2 = 83%) ( Figure 4 ).…”

“…Fat-free mass was recorded in 2 WBV [ 39 , 83 ], 7 RT [ 55 , 62 , 73 , 74 , 75 , 76 , 81 ], and 1 EMS studies [ 84 ], with a very small and statistically non-significant reduction across studies (MD = −0.27 kg (−0.84–0.31 kg); p = 0.46; I 2 = 0%). The pooled effect of the two WBV studies showed a slight increase (MD = 0.53 kg (−1.75–2.81 kg); p = 0.15), as did one EMS study (MD = 0.61 kg (−0.81–2.03 kg); p = 0.40), while there was a small and statistically non-significant decrease across RT interventions (MD = −0.60 kg (−1.28–0.09 kg); p = 0.09).…”

“…Body fat mass was reported in 2 WBV [ 39 , 41 ] and 14 RT (16 intervention groups) studies [ 45 , 50 , 53 , 55 , 58 , 62 , 70 , 71 , 73 , 74 , 76 , 80 , 81 , 85 ], with a statistically significant decrease overall (SMD = −0.65 (−1.09–−0.21); p < 0.001; I 2 = 86%). For the purposes of MD calculation, three studies (4 intervention groups) [ 45 , 58 , 74 ] that reported body mass in kg instead of the percentage of body weight were removed and the analysis was repeated. SMD slightly increased (SMD = −0.74) and MD calculation showed a mean reduction of body fat mass percentage of −1.99% (−3.75–−0.22%).…”

“…Nine RT studies [ 44 , 50 , 67 , 70 , 74 , 77 , 78 , 82 ] and one EMS study [ 86 ] also reported the sarcopenia index (sometimes termed skeletal muscle index) ( Figure 5 ). Mainly (7 studies), the index was computed as the ratio of appendicular skeletal muscle mass and the square body height.…”