The effect of intradialytic exercise twice a week on the physical capacity, inflammation, and nutritional status of dialysis patients: A randomized controlled trial

Abstract

Introduction: Inactivity, uremia, and malnutrition in dialysis patients may lead to decreased muscle mass and physical capacity. As a preventative measure, dialysis patients are provided with an intradialytic exercise program. Our study aimed to determine the role of intradialytic exercise performed 2 times per week on physical capacity, inflammation, and nutritional status in dialysis patients and to determine which exercises are more suitable for this population. Methods: A randomized clinical trial in which participants were randomly assigned to 1 of 3 groups, i.e., a group of patients performing aerobic exercise, a group of patients performing a combination of aerobic and resistance exercise and the control group. The study was conducted at the Dialysis Unit of Dr. Cipto Mangunkusumo General Hospital, Jakarta for 12 weeks from February to May 2018. The inclusion criteria were dialysis patients aged over 18 years who had undergone routine dialysis for over 3 months. Findings: A total of one hundred twenty patients were included in the study. There was a significant increase in lower extremity strength in the group performing aerobic exercise and in the combined exercise group compared to the lower extremity strength of the control group. There was also a significant increase in the physical component score (PCS) of the KDQOL‐SF™ instrument in the aerobic training and combination exercise groups compared to the PCS of the control group. No significant differences were found between the combination exercise group and the aerobic training group in any outcome. Discussion: Both types of exercise programs significantly increased the lower extremity muscle strength and the PCS of the quality of life index. Combination exercise was not more effective than aerobic exercise for dialysis patients.

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

“…In 11 studies, high or low unclear risk of bias was detected due to the absence of blinding of participants and/or outcome assessment [ 49 , 50 , 51 , 52 , 53 , 55 , 57 , 60 , 62 , 64 , 65 ]. Five studies were considered as low or unclear risk of bias because of selective reporting [ 49 , 55 , 57 , 62 , 65 ], and in only three studies high, or unclear risk of bias was detected due to the incomplete outcome of the data [ 55 , 63 , 66 ]. A summary of the assessment of risk of bias can be found in Figure 2 and Figure 3 .…”

“…Two studies included in this systematic review examined changes in SMI, and both of them concluded that there was a significant improvement in SMI in the intervention group [ 59 , 65 ]. Resistance training with high-load led to a greater increase in SMI compared to the moderate-load group [ 59 ].…”

“…Resistance training with high-load led to a greater increase in SMI compared to the moderate-load group [ 59 ]. Moreover, in the aerobic exercise groups, the increase in SMI was greater than in the combined aerobic-resistance exercise group (0.15 versus 0.04, p < 0.05) [ 65 ]. The relevant results are presented in Table 6 .…”

“…Incomplete studies, studies with different control groups, studies not in the English language, or published before 2000 were excluded. As a result, 18 RCT studies [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 ] were characterized as acceptable; details regarding the eligibility process can be found in the flow diagram presented in Figure 1 .…”

Korelasi kadar Fibroblast Growth Factor-23 dengan Kekuatan Genggam Tangan pada Pasien Hemodialisis Dua Kali Seminggu

“…18 Penelitian yang dilakukan Suhardjono, dkk. 19 tahun 2018 pada pasien hemodialisis di RSCM mendapati bahwa sekitar 56,9% subjek dalam kategori inaktif dan aktif minimal sekitar 39%. Hal tersebut memungkinkan terjadinya penurunan kekuatan genggam tangan.…”