Mo068high Intensity Interval Training Improves Physical Functioning, Inflammation and Quality of Life in Peritoneal Dialysis Patients

Abstract

to Exercise in Physiological and Pathological condition, Clermont Ferrand, FRANCE Introduction and Aims: The aim of the study was to measure the effect of a 3-month High-Intensity Interval Training (HIIT) program on physical functioning, metabolic profile and quality of life in peritoneal dialysis (PD) patients. Methods: Twelve patients (age of 63,89 ± 2,81 years; BMI of 29,42 ± 1,66) were randomly assigned to exercise (EX; n= 8) or control (CON; n= 4) group. The trained patients performed two bicycle-HIIT sessions per week during 12 weeks. HIIT protocol consisted of repeated 8s of sprinting and 12s of turning the pedals over slowly throughout 20 min for a maximum of 60 repeats a session. The HIIT session was followed by 15 min of stretching. Physical functioning ( peak oxygen uptake and the 6-minute walk test (6MWT)), lipid profile (triglycerides (TG), total cholesterol, high-density lipoprotein, and low-density lipoprotein (LDL)), hemoglobin (Hb) and inflammatory status (CRPus, TNF-α, IL-6, IL-10) were measured before, after the intervention program and 3 months after the end of the intervention program. Energy intake, physical activity level and the quality of life were also evaluated using questionnaires (food questionnaire, IPAQ, SF-36). Results: A significant improvement of 6MWT and improvement of VO 2 peak were observed in the EX group (+ 20% and + 12%, respectively). Lipid profile was not enhanced in the EX group and may be explained by constant levels of energy intake and daily living physical activity. Hemoglobin did not change after the 3-month program in CON or EX group but the mean dose of Erythropoietin Stimulating Agent was reduced in the EX group (-95% against 6% in the CON group). Plasma CRPus, IL-6 and TNF-α levels decreased in the EX group after the HIIT program but remained stable in the CON group. Three months after the intervention program, IL-6 and TNF-α decrease and come back at their initial (M0) value. Plasma IL-10 levels were not altered in any groups. In the EX group, Quality of life was improved for the items representing physical pain limitations (+22,39%), mental pain limitations (+6,25%), relationships (+6,67%) and general health (+2,6%). Conclusions: Our study is the first to demonstrate that a 3-month HIIT program is effective in PD patients to improve physical functioning, inflammation and certain items associated with the quality of life. HIIT appears as a time-efficient strategy and could be proposed in PD patients as an alternative to the classical moderate intensity continuous training (MICT).

Exercise and physical activity for people receiving peritoneal dialysis: Why not?

“…We encourage PD patients to perform light resistance with weights and encourage swimming in both lakes and swimming pools as long as they clean their access site and change the dressing following swimming. We have seen no association between our swimmers versus nonswimmers and infection rates …”

“…Physical activity includes all movement made through muscle activity that increases energy use while exercise has the elements of planned, structured physical activity that goes beyond just any activity . Even though PD patients may not feel comfortable undertaking exercise, success has been seen in twice‐weekly activity groups in France where low intensity aerobic and resistance exercise programs have been in place for over 2 years . These programs include both a nephrologist and a sports teacher in two rented sports rooms, in a hospital and in a municipal fitness room; the sessions are led by the sports teacher.…”

“…19 Even though PD patients may not feel comfortable undertaking exercise, success has been seen in twice-weekly activity groups in France where low intensity aerobic and resistance exercise programs have been in place for over 2 years. 20 These programs include both a nephrologist and a sports teacher in two rented sports rooms, in a hospital and in a municipal fitness room; the sessions are led by the sports teacher. Every patient can apply, but entrance into the program has to be approved by the patient's nephrologist.…”