Influence of Physical Exercise on the Dialytic Adequacy Parameters of Patients on Hemodialysis

Testal, Alicia García; Maset, Rafael García; Marín, David Hervás; Pérez‐Domínguez, Borja; Maicas, Pilar Royo; Salvador, Inmaculada Soledad Rico; Meléndez‐Oliva, Erika; Aracil, Javier Molina; Chiva, MaJosé Murgui; Blanco, Olga Del pozo; Díaz, Pau Olagüe; Najera, Jose Enrique Fernández; Juan, Eduardo Torregrosa De; Carrera, Caterina Benedito; Segura‐Ortí, Eva

doi:10.1111/1744-9987.12762

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…The results have been positive, since the participants maintained clinical and hemodynamic stability. Although this contrasts with other studies, the use of VR may have elements that increase stability. Further investigation to confirm that intradialytic VR exercise is safe during the whole session is necessary to facilitate intradialytic VR exercise implementation in normal routine practice.…”

Section: Discussionmentioning

confidence: 62%

“…A major barrier to intradialytic exercise implementation is the risk of hemodynamic instability. We have previously verified that conventional exercise is safe during the first 2 hours of HD sessions . Extending the intradialytic exercise period could increase the chances of exercise implementation.…”

Section: Discussionmentioning

confidence: 79%

“…We have previously verified that conventional exercise is safe during the first 2 hours of HD sessions. 16 Extending the intradialytic exercise period could increase the chances of exercise implementation. We have implemented intradialytic VR exercise both in the first and in the second part of the HD session.…”

Section: Discussionmentioning

confidence: 99%

“…Intradialytic exercise can obtain higher adherence rates than interdialytic exercise, particularly if supported by exercise professionals . Literature in the field of renal rehabilitation recommends exercise implementation in the first part of the HD session to avoid hemodynamic instability. To test this theory, Parsons et al exercised through to the third hour of dialysis.…”

Section: Virtual Reality Exercise: At the Beginning Or End Of Dialysis?mentioning

confidence: 99%

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Intradialytic virtual reality exercise: Increasing physical activity through technology

Segura‐Ortí

García-Testal

2019

Seminars in Dialysis

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Intradialytic exercise can improve physical function and health‐related quality of life (HRQoL) in hemodialysis (HD) patients, but is not implemented in routine clinical practice. Virtual reality (VR) exercise has resulted in benefits in non‐dialysis contexts, but implementation in HD patients has been limited. The aim of this review was to provide an overview of VR, present the results of a 12‐week intradialytic VR exercise intervention, and compare VR to conventional exercise. The secondary aim was to review the effect of VR exercise during the last 30 minutes of the HD session on hemodynamic stability. We conclude that VR exercise during HD is safe and can improve physical function and HRQoL, and can be performed safely toward the end of the HD session.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Virtual Reality Exercise: At the Beginning Or End Of Dialysis?mentioning

confidence: 99%

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Intradialytic virtual reality exercise: Increasing physical activity through technology

Segura‐Ortí

García-Testal

2019

Seminars in Dialysis

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Exercise training for adults undergoing maintenance dialysis

Bernier-Jean

Beruni

Bondonno

et al. 2022

Cochrane Database of Systematic Reviews

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Efficacy of six exercise-based interventions for individuals undergoing hemodialysis: a network meta-analysis of randomized clinical trials

Ferrari

Andrade

Teixeira

et al. 2023

Nephrology Dialysis Transplantation

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Background Evidence comparing different exercise modalities in individuals undergoing hemodialysis remains incipient. Our aim was to conduct a systematic review and network meta-analysis of randomized clinical trials to compare and synthesize the efficacy of five different intradialytic exercise modalities and home-based training in this population. Design, setting, participants, & measurements Studies were searched in PubMed/MEDLINE, Cochrane Library, Embase, Cinahl, and Scopus from their inception to September 19, 2022. We used traditional random-effects models and Bayesian network meta-analysis models. The risk of bias was assessed by the RoB 2.0 tool, and the assessment of confidence in the results through the CINeMA tool. Results Seventy-eight studies involving 3,326 participants were included. Our network meta-analysis showed that combined training was the intervention with the best performance to increase VO2peak (mean difference [MD] = 3.94 mL.kg.min; 95% credible interval [CrI], 2.38 to 5.76) and to reduce diastolic blood pressure (MD = −5.19 mmHg; 95%CrI, −9.35 to −0.96) compared to the usual care group. Inspiratory muscle training was the intervention that most improved the 6-minute walk test distance (MD = 70.97 m; 95%CrI, 18.09 to 129.87). C-reactive protein decreased in resistance training (MD = −2.6 mg/L; 95%CrI, −4.97 to −0.33) and aerobic training (MD = −1.4 mg/L; 95%CrI, −3.15 to −0.06). Kt/V improved in aerobic training (MD = 0.11; 95%CrI, 0.02 to 0.18), and SF-36 physical functioning outcomes improved in resistance training (MD = 10.66 points; 95%Crl, 1.91 to 20.22). No intradialytic exercise modality was superior to others or comparable with home-based training in improving the evaluated outcomes. Subgroup analysis revealed that exercise interventions >12 weeks improved functional capacity more than interventions ≤12 weeks, and that combined training reduces diastolic blood pressure only after 12 weeks of follow-up. Furthermore, our results suggest that moderate or moderate-to-vigorous intensity training leads to more pronounced improvements in functional capacity, while mild or mild-to-moderate intensity training does not have the same effect. In this review, most of the included studies were assessed as having some concern, which resulted in a low to very low level of confidence in the overall findings. Conclusions Both intradialytic training and home-based training can promote benefits for individuals undergoing hemodialysis, with no evidence of the superiority of either training modality over the other.

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Influence of Physical Exercise on the Dialytic Adequacy Parameters of Patients on Hemodialysis

Cited by 4 publications

References 34 publications

Intradialytic virtual reality exercise: Increasing physical activity through technology

Intradialytic virtual reality exercise: Increasing physical activity through technology

Exercise training for adults undergoing maintenance dialysis

Efficacy of six exercise-based interventions for individuals undergoing hemodialysis: a network meta-analysis of randomized clinical trials

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