Sage Journals: Discover world-class research

Abstract

Objective:

This study aimed to investigate the effect of continuous progressive resistance training on body composition, functional capacity and self-reported quality of life in end-stage renal disease patients.

Design:

A randomized controlled trial.

Subjects:

The study included 52 hemodialysis patients (aged 55.7 ± 14.03 years) randomized into exercise (progressive resistance training (PRT), n = 28) or control (CON, n = 24) groups.

Intervention:

Patients randomized into the PRT group received prescribed strength exercises in two sets of 15–20 repetitions, in a repetition maximum training zone regime, thrice a week for 12 weeks, during hemodialysis. Patients randomized into the CON group received a sham-exercise with active mobilization of the arms and legs without load and progression.

Main outcome measure:

Body composition using dual-energy X-ray absorptiometry (DXA), strength using handgrip dynamometry (HGS), repeated sit-to-stand test (STT), 6-minute walk test, flexibility and the SF-36 questionnaire (quality of life (QoL)) were assessed at baseline and at 12 weeks.

Results:

Leg lean mass (P = 0.04, effect size (ES) of 0.56), bone mineral content (P = 0.02, ES of 0.65), leg strength in STT repetitions (P = 0.01, ES of 0.66) and flexibility (P < 0.01, ES of 1.03) were significantly improved in the PRT group compared to the CON group. Walking capacity, HGS and QoL were not different between the groups.

Conclusion:

12 weeks of PRT with a repetition maximum training zone regime provided significant load to increase leg lean mass and STT performance as well as bone mineral content, compared to the CON, which continued to deteriorate. There was lack of efficacy on walking test, HGS and QoL.

Keywords

Renal failure hemodialysis strength training physical capacity exercise

Get full access to this article

View all access options for this article.

References

Carrero

Stenvinkel

Cuppari

et al . Etiology of the protein-energy wasting syndrome in chronic kidney disease: a consensus statement from the International Society of Renal Nutrition and Metabolism (ISRNM). J Ren Nutr 2013; 23: 77–90.

Kittiskulnam

Carrero

Chertow

et al . Sarcopenia among patients receiving hemodialysis: weighing the evidence. J Cachexia Sarcopenia Muscle 2016; 8: 57–68.

Rosa

CSC

Bueno

Souza

et al . Factors associated with leisure-time physical activity among patients undergoing hemodialysis. BMC Nephrol 2015; 16: 192.

Johansen

Chertow

Silva

et al . Determinants of physical performance in ambulatory patients on hemodialysis. Kidney Int 2001; 60: 1586–1591.

Beddhu

Pappas

Ramkumar

et al . Effects of body size and body composition on survival in hemodialysis patients. J Am Soc Nephrol 2003; 14: 2366–2372.

Pescatello

(ed.). ACSM’s guidelines for exercise testing and prescription. Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins Health, 2014.

Rhee

Kalantar-Zadeh

Resistance exercise: an effective strategy to reverse muscle wasting in hemodialysis patients?

J Cachexia Sarcopenia Muscle 2014; 5: 177–180.

Johansen

Painter

Sakkas

et al . Effects of resistance exercise training and nandrolone decanoate on body composition and muscle function among patients who receive hemodialysis: a randomized, controlled trial. J Am Soc Nephrol 2006; 17: 2307–2314.

Segura-Ortí

Kouidi

Lisón

JF.

Effect of resistance exercise during hemodialysis on physical function and quality of life: randomized controlled trial. Clin Nephrol 2009; 71: 527–537.

10.

Kirkman

Mullins

Junglee

et al . Anabolic exercise in haemodialysis patients: a randomised controlled pilot study. J Cachexia Sarcopenia Muscle 2014; 5: 199–207.

11.

Song

Sohng

KY.

Effects of progressive resistance training on body composition, physical fitness and quality of life of patients on hemodialysis. J Korean Acad Nurs 2012; 42: 947–956.

12.

Chen

JLT

Godfrey

et al . Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: a randomized pilot trial. Nephrol Dial Transplant 2010; 25: 1936–1943.

13.

Kopple

Wang

Casaburi

et al . Exercise in maintenance hemodialysis patients induces transcriptional changes in genes favoring anabolic muscle. J Am Soc Nephrol 2007; 18: 2975–2986.

14.

Cheema

Abas

Smith

et al . Progressive exercise for anabolism in kidney disease (PEAK): a randomized, controlled trial of resistance training during hemodialysis. J Am Soc Nephrol 2007; 18: 1594–1601.

15.

Marinho

Mafra

Pelletier

et al . In hemodialysis patients, intradialytic resistance exercise improves osteoblast function: a pilot study. J Ren Nutr 2016; 26: 341–345.

16.

Campos

Luecke

Wendeln

et al . Muscular adaptations in response to three different resistance-training regimens: specificity of repetition maximum training zones. Eur J Appl Physiol 2002; 88: 50–60.

17.

Arifin

. Random sampling and allocation using SPSS. Educ Med J 4: e129–e143. DOI: 10.5959/eimj.v4i1.4.

18.

Wang

Faith

et al . Regional skeletal muscle measurement: evaluation of new dual-energy X-ray absorptiometry model. J Appl Physiol 1999; 87: 1163–1171.

19.

American Thoracic Society/European Respiratory Society. ATS/ERS Statement on respiratory muscle testing. Am J Respir Crit Care Med 2002; 166: 518–624.

20.

Bohannon

RW.

Sit-to-stand test for measuring performance of lower extremity muscle. Percept Mot Skills 1995; 80: 163–166.

21.

Qureshi

Blaner

Berglund

et al . Hand-grip muscle strength, lean body mass, and plasma proteins as markers of nutritional status in patients with chronic renal failure close to start of dialysis therapy. Am J Kidney Dis 2000; 36: 1213–1225.

22.

Wells

Dillon

EK.

The sit and reach—a test of back and leg flexibility. Res Quart 1952; 23: 115–118.

23.

Ciconelli

Ferraz

Santos

et al . Tradução para a língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol 1999; 39: 143–150.

24.

Ribeiro

Coutinho

Iuras

et al . Effect of resistance exercise intradialytic in renal patients chronic in hemodialysis. J Bras Nefrol 2013; 35: 13–19.

25.

Cheema

Abas

Smith

et al . Randomized controlled trial of intradialytic resistance training to target muscle wasting in ESRD: the Progressive Exercise for Anabolism in Kidney Disease (PEAK) study. Am J Kidney Dis 2007; 50: 574–584.

26.

Marinho

Moraes

Barbosa

et al . Exercise training alters the bone mineral density of hemodialysis patients. J Strength Cond Res 2016; 30: 2918–2923.

27.

Desmet

Beguin

Swine

et al . Falls in hemodialysis patients: prospective study of incidence, risk factors, and complications. Am J Kidney Dis 2005; 45: 148–153.

28.

Dobsak

Homolka

Svojanovsky

et al . Intra-dialytic electrostimulation of leg extensors may improve exercise tolerance and quality of life in hemodialyzed patients. Artif Organs 2012; 36: 71–78.

29.

Koh

Fassett

Sharman

et al . Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: a randomized pilot study. Am J Kidney Dis 2010; 55: 88–99.

30.

Wilund

Tomayko

et al . Intradialytic exercise training reduces oxidative stress and epicardial fat: a pilot study. Nephrol Dial Transplant 2010; 25: 2695–2701.

31.

Orcy

Dias

Seus

et al . Combined resistance and aerobic exercise is better than resistance training alone to improve functional performance of haemodialysis patients—results of a randomized controlled trial. Physiother Res Int 2012; 17: 235–243.

32.

Rocha

Magalhães

Lima

et al . Repercussão de um protocolo fisioterapêutico intradialítico na funcionalidade pulmonar, força de preensão manual e qualidade de vida de pacientes renais crônicos. J Bras Nefrol 2010; 32: 359–371.

33.

Matsufuji

Shoji

Yano

et al . Effect of chair stand exercise on activity of daily living: a randomized controlled trial in hemodialysis patients. J Ren Nutr 2015; 25: 17–24.

34.

Lindheimer

O’Connor

Dishman

RK.

Quantifying the placebo effect in psychological outcomes of exercise training: a meta-analysis of randomized trials. Sports Med 2015; 45: 693–711.

35.

Kraemer

Ratamess

NA.

Fundamentals of resistance training: progression and exercise prescription. Med Sci Sports Exerc 2004; 36: 674–688.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.36 MB

Effect of continuous progressive resistance training during hemodialysis on body composition,physical function and quality of life in end-stage renal disease patients: a randomized controlled trial