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Yin J, Zhang X, Wang Z, Qu Z, Sun X, Song Y, Zhang H. Application of exercise therapy in patients with chronic kidney disease-induced muscle atrophy: a scoping review. BMC Sports Sci Med Rehabil 2024; 16:100. [PMID: 38689329 PMCID: PMC11061900 DOI: 10.1186/s13102-024-00876-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/03/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND The prevalence of muscle atrophy in patients suffering from chronic kidney disease (CKD) presents a significant challenge to healthcare providers, necessitating innovative approaches to management and care. Against this backdrop, this study embarks on a comprehensive review of literature concerning the application of exercise interventions in the nursing care of these patients. Such interventions are critical in addressing the debilitating effects of the condition, which include progressive loss of muscle mass and strength, adversely affecting patient mobility, quality of life, and overall survival. This review aims to identify the specific exercise modalities, contents, outcome indicators, and application effects associated with this intervention, in the context of the complex interplay of metabolic, inflammatory, and hormonal factors contributing to muscle wasting in CKD patients. By examining the efficacy of various exercise interventions, this study seeks to elucidate optimal strategies for mitigating the impact of CKD-induced muscle atrophy, thereby informing clinical practices and improving patient outcomes. METHODS According to the method of a scoping review, nine databases (Cochrane, PubMed, EMBASE, Web of Science, ProQuest, Ovid, CNKI, Wanfang Data, and VIP) were searched until September 28, 2023. The included literature was screened, summarized, and analyzed. RESULTS A total of 20 pieces of literature were included. Some types include aerobic exercise, resistance exercise, and aerobic combined resistance exercise. The exercise intensity primarily falls within the mild to moderate range, with a recommended frequency of 2 - 3 times a week, lasting 30 - 60 min each time. The types of outcomes encompassed in this study include body composition, functional testing, strength measurements, laboratory examinations, cardiopulmonary function assessments, and patient-reported outcomes. To varying degrees, exercise intervention positively impacts the subjects' physical activity ability, body composition, and skeletal muscle status. Currently, resistance training is the primary type of intervention used for preventing and treating CKD patients induced by muscle atrophy. CONCLUSION Exercise intervention can improve muscle strength, physical function, and quality of life in patients with CKD muscle atrophy. Therefore, patients should be fully informed of the effect of exercise intervention in the treatment of chronic kidney disease-induced muscle atrophy in future, so as to promote the standardized implementation of exercise intervention.
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Affiliation(s)
- Jiawei Yin
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Xiaotu Zhang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Zilin Wang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Zihan Qu
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Xuefeng Sun
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Yuqing Song
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China
| | - Hongshi Zhang
- Changchun University of Chinese Medicine, No.1035, Boshuo Road, Jingyue Development District, Changchun, 130117, China.
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Martins MA, Ghisi GLM, da Silva KB, Leopoldino G, Pakosh M, Bundchen DC. Psychometrically validated questionnaires to measure the effects and benefits/barriers to physical exercise in hemodialysis patients: a systematic review. Disabil Rehabil 2024; 46:1459-1470. [PMID: 37052210 DOI: 10.1080/09638288.2023.2198258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 03/25/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE To provide a critical assessment, summarize, and synthesize the evidence from studies using psychometrically validated questionnaires to assess the effects and benefits/barriers of physical exercise in hemodialysis patients. METHODS The search was performed on six electronic databases. It was conducted following the PRISMA statement and the PICO framework. The methodological quality was assessed using the MMAT. Were used the quality criteria for psychometric properties developed by Terwee et al. RESULTS Overall, 70 studies were included, and 39 questionnaires identified, evaluating 13 outcomes. The quality of the psychometric properties of the questionnaires was not always described; only 13 presented positive ratings on > =6/9 properties. The most assessed measure was criterion validity, and the least assessed criteria was responsiveness. The most outcome measured by these questionnaires was quality of life using SF-36, followed by psychological health using the BDI. The DPEBBS was the only instrument identified that assessed the benefits and barriers of exercise. CONCLUSION Quality of life and depression were the most frequent outcomes. Other measures contemplating physical, mental, cognitive performance, and especially of the perceptions benefits and barriers to exercise should be further investigated. We have clearly identified the need for more studies evaluating psychometric measures that have not been tested satisfactorily or hardly been tested at all.
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Affiliation(s)
- Marcieli A Martins
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | - Gabriela L M Ghisi
- Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Kenia B da Silva
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | - Gabriela Leopoldino
- Postgraduate Program in Cardiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Maureen Pakosh
- Library and Information Services, University Health Network, Toronto, Canada
| | - Daiana C Bundchen
- Postgraduate Program in Rehabilitation Sciences, Federal University of Santa Catarina, Araranguá, Brazil
- Department for Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil
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Elia R, Piva G, Bulighin F, Lamberti N, Manfredini F, Gambaro G, Di Maria A, Salvagno G, Carbonare LGD, Storari A, Valenti MT, Battaglia Y. The Impact of Physical Exercise on microRNAs in Hemodialysis Patients: A Review and a Protocol for an Ancillary Study. Biomedicines 2024; 12:468. [PMID: 38398071 PMCID: PMC10886953 DOI: 10.3390/biomedicines12020468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/12/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Physical inactivity is considered a significant risk factor for mortality and morbidity among chronic hemodialysis (HD) patients. Therefore, physical exercise is recommended in the treatment of HD patients. Although the beneficial effects of physical exercise in HD patients are well-described in the literature, the underlying physiological mechanisms still need to be fully understood. Recently, microRNAs (miRNAs) have emerged as potential mediators of the therapeutic effects of physical exercise in healthy individuals. miRNAs are short, single-stranded, noncoding RNAs involved in gene expression regulation. Specifically, upon forming the RNA-induced silencing complex, miRNAs selectively bind to specific miRNAs within cells, reducing gene expression. miRNAs can be secreted by cells in an accessible form or enclosed within exosomes or extracellular vesicles. They can be detected in various body fluids, including serum (circulating miRNAs), facilitating the study of their diverse expression. Currently, there is no available data regarding the impact of physical exercise on the expression of miRNAs involved in osteogenic differentiation, a fundamental mechanism in the development of vascular calcification, for HD patients. Therefore, we have designed an observational and longitudinal case-control study to evaluate the expression of miR-9 and miR-30b in HD patients participating in a 3-month interdialytic physical exercise program. This paper aims to present the study protocol and review the expression of circulating miRNAs in HD patients and their modulation through physical exercise.
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Affiliation(s)
- Rossella Elia
- PhD Program in Clinical and Experimental Biomedical Sciences, Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Giovanni Piva
- PhD Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, 44122 Ferrara, Italy;
| | - Francesca Bulighin
- Nephrology and Dialysis Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy;
- Department of Medicine, University of Verona, 37129 Verona, Italy
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44122 Ferrara, Italy; (N.L.); (F.M.)
| | - Fabio Manfredini
- Department of Neuroscience and Rehabilitation, University of Ferrara, 44122 Ferrara, Italy; (N.L.); (F.M.)
| | - Giovanni Gambaro
- Nephrology and Dialysis Unit, Department of Medicine, University of Verona, 37129 Verona, Italy;
| | - Alessio Di Maria
- Nephrology and Dialysis Unit, University Hospital of Ferrara, 44122 Ferrara, Italy; (A.D.M.); (A.S.)
| | - Gianluca Salvagno
- Section of Clinical Biochemistry, University of Verona, 37129 Verona, Italy;
| | - Luca Giuseppe Dalle Carbonare
- Internal Medicine, Section D, Department of Medicine, University of Verona, 37129 Verona, Italy; (L.G.D.C.); (M.T.V.)
| | - Alda Storari
- Nephrology and Dialysis Unit, University Hospital of Ferrara, 44122 Ferrara, Italy; (A.D.M.); (A.S.)
| | - Maria Teresa Valenti
- Internal Medicine, Section D, Department of Medicine, University of Verona, 37129 Verona, Italy; (L.G.D.C.); (M.T.V.)
| | - Yuri Battaglia
- Nephrology and Dialysis Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy;
- Department of Medicine, University of Verona, 37129 Verona, Italy
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A multicomponent exercise program improves functional capacity and respiratory muscle strength in hemodialysis patients: a randomized clinical trial. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-023-01053-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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5
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Andrade FP, Ribeiro HS, Benvenutti H, de Oliveira SG, Thomé FS, Veronese FV, Rovedder PME. Six-minute walk test may be a reliable predictor of peak oxygen uptake in patients undergoing hemodialysis. RENAL REPLACEMENT THERAPY 2023. [DOI: 10.1186/s41100-023-00460-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Abstract
Background
Cardiorespiratory fitness seems to play an important role in the general health of patients undergoing hemodialysis (HD). However, the prediction of peak oxygen uptake (V̇O2peak) in a clinical setting is not widely adopted for these patients.
Objectives
Evaluate the agreement and reliability between directly and indirectly V̇O2peak measurements in patients undergoing HD.
Methods
This is a cross-sectional study with patients undergoing HD that performed a cardiopulmonary exercise test (CPET) with 5/10 watts incremental load in each minute using a cycle ergometry to directly evaluate the V̇O2peak, and the 6-min walk test (6MWT) in a 30-m corridor to indirect measures it. Both tests were performed on a midweek non-dialysis day. Bland–Altman analysis of agreement limits was used with direct and indirect V̇O2peak values. Intraclass correlation coefficient (ICC) and Cronbach’s Alpha was used to evaluate the reproducibility and reliability between direct and indirect V̇O2peak values.
Results
Twenty-six patients (54.4 ± 14.5 years, 53.8% of male) were evaluated. The V̇O2peak direct mean obtained through CPET was 15.91 ± 5.26 (ml/kg/min), while the indirect mean obtained through 6MWT was V̇O2peak of 14.89 ± 4.21 (ml/kg/min). There was a strong positive correlation between both V̇O2peak values (r = 0.734; p < 0.001). The Bland–Altman analysis demonstrated that the methods agreed with each other (p = 0.103). Also, the ICC (0.829) and Cronbach's Alpha (0.846) showed excellent reproducibility and reliability.
Conclusions
6MWT is a reliable tool for estimating V̇O2peak in patients undergoing HD.
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Brito JS, Reis D, Silva G, Fonseca L, Ribeiro M, Chermut T, Oliveira L, Borges NA, Ribeiro-Alves M, Mafra D. Bicycle ergometer exercise during hemodialysis and its impact on quality of life, aerobic fitness and dialysis adequacy: A pilot study. Complement Ther Clin Pract 2022; 49:101669. [PMID: 36152526 DOI: 10.1016/j.ctcp.2022.101669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic kidney disease patients on hemodialysis commonly have a worse quality of life (QoL) due to complications of the disease and dialysis procedure. Physical exercise has emerged as a strategy to improve this scenario. The objective of this study was to evaluate the effect of an intradialytic aerobic exercise program on QoL and aerobic fitness in hemodialysis patients. MATERIAL AND METHODS These are a secondary analysis of clinical trial data previously published in which hemodialysis patients were randomized into "bike group" (using an adapted exercise bicycle) or "control group" (usual care). The exercise sessions lasted 45 min (5 min of warm-up, 35 min of moderate-intensity and 5 min of cool-down) three times/week for three months. The QoL domains were assessed using the SF-36 QoL questionnaire. Aerobic fitness was evaluated using the 6-min walk test (6MWT). Circulating cytokines, biochemical parameters and Kt/V were also assessed. RESULTS Nine patients completed three months of exercise (5 men, 44 ± 11 years), and nine were in the control group (6 men, 44 ± 14 years). In the bike group, there was a trend to improve the physical role domain (p = 0.06) regarding QoL, an improvement in the 6MWT (p = 0.02), and in the Kt/V (p = 0.03) after three months. There was a positive correlation between the general health domain and Kt/V (r = 0.691; p = 0.003) and an inverse correlation between the physical functioning domain and plasma TNF-α levels (r = -0.514; p = 0.04). CONCLUSIONS 12 weeks of intradialytic aerobic exercise was enough to benefit hemodialysis patients' quality of life, aerobic fitness, and quality of dialysis. CLINICALTRIALS gov id: NCT04375553.
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Affiliation(s)
- Jessyca S Brito
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil.
| | - Drielly Reis
- Graduate Program in Medical Clinic, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Greicielle Silva
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Larissa Fonseca
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Marcia Ribeiro
- Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Tuany Chermut
- Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Leonardo Oliveira
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil
| | - Natália A Borges
- Graduate Program in Cardiovascular Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Institute of Nutrition, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Marcelo Ribeiro-Alves
- HIV/AIDS Clinical Research Center, National Institute of Infectology Evandro Chagas (INI/Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Denise Mafra
- Graduate Program in Medical Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Graduate Program in Nutrition Sciences, Fluminense Federal University (UFF), Niterói, RJ, Brazil; Graduate Program in Biological Sciences, Physiology, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Yamaguchi Y, Greiner C, Lee SC, Ryuno H, Yen HY, Lin CF, Lee TI, Lee PH. Lifestyle factors associated with muscle quality in community-dwelling older people with type 2 diabetes in Japan and Taiwan: a cross-sectional study. Psychogeriatrics 2022; 22:736-742. [PMID: 35853561 DOI: 10.1111/psyg.12878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/24/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM), common in older people, is an important reason for muscle loss in Japanese and Taiwanese populations. However, little is known about the association between lifestyle behaviours and muscle quality. We aimed to compare the lifestyle behaviours of Japanese and Taiwanese older adults with T2DM and to the identify lifestyle factors associated with muscle quality. METHODS This cross-sectional study was conducted among community-dwelling individuals with T2DM aged ≥65 years in Taiwan and Japan. Totally, 114 Japanese and 226 Taiwanese participants were enrolled in the study. Outcomes were measured by blood biochemical examinations, body composition analyses and structured self-reported questionnaires to assess lifestyle behaviours and muscle quality. Linear regression models were used to examine the relationship between lifestyle factors and muscle quality using SPSS version 27.0 with a statistical significance level of P < 0.05. RESULTS Japanese subjects were more likely to be smokers and alcohol consumers, and they were less likely to have well-balanced diets and engage in more physical activity as compared to Taiwanese subjects. The muscle quality in the Japanese subjects was significantly poorer than that in the Taiwanese subjects. Physical activity, dietary habits and smoking were associated with muscle quality, after adjusting for age, gender and body mass index. CONCLUSIONS Physical activity of insufficient intensity, unhealthy dietary habits and smoking could be risk factors for poor muscle quality. These findings can contribute to the development of effective strategies to improve muscle quality in community-dwelling older Asian people with T2DM.
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Affiliation(s)
- Yuko Yamaguchi
- Department of Nursing, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Chieko Greiner
- Department of Nursing, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shu-Chun Lee
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hirochika Ryuno
- Department of Nursing, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Chiou-Fen Lin
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ting-I Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Pi-Hsia Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Chang HC, Chen CH, Cheng YY. Therapeutic Effects of Intradialytic Exercise on Life Quality of Patients with End-Stage Renal Disease: Study Protocol for a Randomized Control Trial. Healthcare (Basel) 2022; 10:healthcare10061103. [PMID: 35742154 PMCID: PMC9222984 DOI: 10.3390/healthcare10061103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/05/2022] [Accepted: 06/12/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Exercise training has positive effects on physical functions and could reduce a sedentary lifestyle for hemodialysis (HD) patients. Given that low-level physical activity increases morbidity and mortality, here, we aimed to determine the effects of an intradialytic exercise program delivered at different frequencies on HD patients in Taiwan. Methods: This study is a prospective, randomized control trial. An intradialytic exercise program will be arranged for patients after receiving their informed consent. Patients will be segregated at random into three groups as follows: (a) three times/week of intradialytic exercise training plus standard care maintenance of HD, (b) two times/week of intradialytic exercise training plus standard care maintenance of HD, or (c) standard care maintenance of HD. Subjects will be followed for 24 weeks. At three time points, 0, 12, and 24 weeks, the primary outcome, the Short-Form 36 score, will be measured. Additional secondary outcomes to be measured are the Beck depression inventory, 6 min walking test, sit-to-stand test, and anthropometric measures such as the body mass index, thigh circumference, and the proportion of fat in the body composition. Conclusions: There is emerging evidence in support of intradialytic exercise improving health-related quality of life for patients on HD. However, the difference in the therapeutic effects between three times per week and twice per week has never been determined. With this study, we anticipate to fill the knowledge gap in the exercise prescription among HD patients.
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Affiliation(s)
- Hsiang-Chi Chang
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Cheng-Hsu Chen
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402010, Taiwan;
- Department of Nephrology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- Department of Life Science, Tunghai University, Taichung 407224, Taiwan
| | - Yuan-Yang Cheng
- Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402010, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Correspondence: ; Tel.: +886-4-23592525 (ext. 3500)
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9
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The effect of a 6-month intradialytic exercise program on hemodialysis adequacy and body composition: a randomized controlled trial. Int Urol Nephrol 2022; 54:2983-2993. [DOI: 10.1007/s11255-022-03238-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 05/04/2022] [Indexed: 12/25/2022]
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10
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Yuguero-Ortiz A, Gomez M, Arias-Guillén M, Ojeda R, Fontseré N, Rodas L, Jesús Broseta J, Vera M, Hernandez-Sanchez S, Maduell F. Impact and safety outcomes of an intradialytic physical exercise program. Nefrologia 2021; 41:556-565. [PMID: 36165138 DOI: 10.1016/j.nefroe.2021.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Patients undergoing hemodialysis (HD) are characterized by a poor physical condition and a substantial sedentary profile. The implementation of physical exercise programs in the hemodialysis units is usually limited by the inherent safeness and the lack of appropriate resources. OBJECTIVES We aimed to evaluate the impact and safety outcomes of the implementation of an intradialytic physical exercise program (IPE) by a multidisciplinary team (physiotherapist and nursing assistant) in the physical condition of the patients. MATERIAL AND METHODS This six months single-centre and experimental pre-post prospective study was carried out in 34 patients. A two day-week combined IPE intervention was implemented. The cardiopulmonary capacity (6MWT), muscular strength (HG, leg dynamometry and 10STS), body composition (bioimpedance) and coordination capacity (Timed Up and Go test) was assessed at the beginning and at the end of the study. Safety was evaluated by means of the number of issues regarding the vascular access, the hemodynamic stability as well as the vascular refilling profile (RBV) in each session. The adhesion to the program was also registered. Additionally, analytical parameters were recorded. RESULTS The adhesion to an IPE program was high (70.8%). A significant improvement of the cardiopulmonary capacity (6MWT average increase 47 m; p < 0.001), superior limbs (HG average increase of 1.6 kg; p = 0.007) as well as the lower extremities (10STS; p = 0.003; dynamometry p < 0.05). Regarding safeness, there were no incidences neither significant difference in the RBV. CONCLUSIONS A combined IPE may contribute to the improvement of the physical condition of the patients as well as ensures a safe development of the HD treatment. We suggest a multidisciplinary team in order to efficiently establish an IPE program.
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Affiliation(s)
- Anna Yuguero-Ortiz
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - Miquel Gomez
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Marta Arias-Guillén
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Ojeda
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Néstor Fontseré
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Lida Rodas
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - José Jesús Broseta
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Manel Vera
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sonsoles Hernandez-Sanchez
- Department of Physical and Sports Education, School of Sports Science, PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain; Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, Spain
| | - Francisco Maduell
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, Spain
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11
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Yuguero-Ortiz A, Gomez M, Arias-Guillén M, Ojeda R, Fontseré N, Rodas L, Broseta JJ, Vera M, Hernandez-Sanchez S, Maduell F. Impact and safety outcomes of an intradialytic physical exercise program. Nefrologia 2021. [PMID: 33888350 DOI: 10.1016/j.nefro.2020.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Patients undergoing hemodialysis (HD) are characterized by a poor physical condition and a substantial sedentary profile. The implementation of physical exercise programs in the hemodialysis units is usually limited by the inherent safeness and the lack of appropriate resources. OBJECTIVES We aimed to evaluate the impact and safety outcomes of the implementation of an intradialytic physical exercise program (IPE) by a multidisciplinary team (physiotherapist and nursing assistant) in the physical condition of the patients. MATERIAL AND METHODS This six months single-centre and experimental pre-post prospective study was carried out in 34 patients. A two day-week combined IPE intervention was implemented. The cardiopulmonary capacity (6MWT), muscular strength (HG, leg dynamometry and 10STS), body composition (bioimpedance) and coordination capacity (Timed Up and Go test) was assessed at the beginning and at the end of the study. Safety was evaluated by means of the number of issues regarding the vascular access, the hemodynamic stability as well as the vascular refilling profile (RBV) in each session. The adhesion to the program was also registered. Additionally, analytical parameters were recorded. RESULTS The adhesion to an IPE program was high (70.8%). A significant improvement of the cardiopulmonary capacity (6MWT average increase 47m; p<0.001), superior limbs (HG average increase of 1.6kg; p=0.007) as well as the lower extremities (10STS; p=0.003; dynamometry p<0.05). Regarding safeness, there were no incidences neither significant difference in the RBV. CONCLUSIONS A combined IPE may contribute to the improvement of the physical condition of the patients as well as ensures a safe development of the HD treatment. We suggest a multidisciplinary team in order to efficiently establish an IPE program.
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Affiliation(s)
- Anna Yuguero-Ortiz
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España.
| | - Miquel Gomez
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Marta Arias-Guillén
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Raquel Ojeda
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Néstor Fontseré
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Lida Rodas
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - José Jesús Broseta
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Manel Vera
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
| | - Sonsoles Hernandez-Sanchez
- Department of Physical and Sports Education, School of Sports Science, PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Granada, España; Performance and Sport Rehabilitation Laboratory, Faculty of Sport Sciences, University of Castilla-La Mancha, Toledo, España
| | - Francisco Maduell
- Diàlisi i Recerca Aplicada Clínic (DIRAC), Servicio de Nefrología y Trasplante Renal, Hospital Clínic de Barcelona, Barcelona, España
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12
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Myers J, Chan K, Chen Y, Lit Y, Patti A, Massaband P, Kiratli BJ, Tamura M, Chertow GM, Rabkin R. Effect of a Home-Based Exercise Program on Indices of Physical Function and Quality of Life in Elderly Maintenance Hemodialysis Patients. Kidney Blood Press Res 2021; 46:196-206. [PMID: 33774634 DOI: 10.1159/000514269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients on maintenance hemodialysis (MHD) exhibit muscle wasting and impaired physical function which can be reversed with regular exercise, but accessibility to exercise programs for this unique population is lacking. We assessed the efficacy of a home-based exercise program on a broad range of indices of physical function, quality of life (QoL), and cognitive decline in patients with MHD. DESIGN AND METHODS Twenty-eight MHD patients, mean age 66 ± 7 years, were randomized to a 12-week home-based, case-managed aerobic and resistance exercise program or to usual care (13 exercise and 15 usual care). Comparisons were made for peak VO2, ventilatory inefficiency, 6-min walk test (6MWT), 1-min sit-to-stand (1STS), muscle strength, body composition, QoL, and cognitive measures. RESULTS Peak VO2 improved significantly in the exercise group (p = 0.01 between groups); exercise time improved by 41 and 36% at the ventilatory threshold and peak exercise, respectively (p < 0.01 between groups), but there were no differences in ventilatory efficiency. Trends for improvements in 6MWT and 1STS in the exercise group were observed, but no differences were observed in strength or body composition. Among measures of QoL, general health determined by the SF-36 improved in the exercise group, but there were no differences between groups in cognitive function. CONCLUSIONS MHD patients improved exercise capacity and some indices of QoL following a 12-week home-based exercise program. Home-based exercise is feasible for patients undergoing MHD and may help to obviate accessibility barriers to regular exercise.
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Affiliation(s)
- Jonathan Myers
- Cardiology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Cardiology Division, Stanford University, Stanford, California, USA
| | - Khin Chan
- Cardiology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.,Nephrology Section, Veterans Affairs Palo Alto Health Care System, Stanford, California, USA
| | - Yu Chen
- Cardiology Division, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Yiming Lit
- Nephrology Section, Veterans Affairs Palo Alto Health Care System, Stanford, California, USA.,Nephrology Division, Stanford University, Stanford, California, USA
| | - Alessandro Patti
- Division of Sports and Exercise Medicine, University of Padova, Padova, Italy
| | - Payam Massaband
- Division of Sports and Exercise Medicine, University of Padova, Padova, Italy
| | - B Jenny Kiratli
- Spinal Cord Injury Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Manju Tamura
- Nephrology Section, Veterans Affairs Palo Alto Health Care System, Stanford, California, USA.,Nephrology Division, Stanford University, Stanford, California, USA
| | - Glenn M Chertow
- Nephrology Division, Stanford University, Stanford, California, USA
| | - Ralph Rabkin
- Nephrology Section, Veterans Affairs Palo Alto Health Care System, Stanford, California, USA.,Nephrology Division, Stanford University, Stanford, California, USA
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13
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Hatef M, Mousavinasab N, Esmaeili R, Kamali M, Madani Z, Spahbodi F, Shafipour V. The Effects of Exercise Training on Physical Performance and Self-efficacy in Hemodialysis Patients: A Randomized Controlled Clinical Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2020; 25:520-526. [PMID: 33747842 PMCID: PMC7968584 DOI: 10.4103/ijnmr.ijnmr_28_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/28/2020] [Accepted: 08/23/2020] [Indexed: 01/09/2023]
Abstract
Background: Hemodialysis patients are faced with challenges in carrying out their daily activities. Self-efficacy is a social cognitive concept that can affect behavioral control in these patients. Hence, the purpose of the present study was to investigate the effects of exercise training on physical performance and self-efficacy in hemodialysis patients. Materials and Methods: This randomized controlled clinical trial was conducted on 60 hemodialysis patients who visited hospitals affiliated to Mazandaran University of Medical Sciences in Sari, Iran. The participants were randomly divided into two groups. The patients in the intervention/exercise group received the 8-week exercise program. Patients in the control group received routine care. The Six-Minute Walk Test (6MWT) was used to assess the patients' functional ability and the Exercise Self-Efficacy Scale (ESES) and Chronic Disease Self-Efficacy Scale (CDSES) were used to assess their self-efficacy before and 2 and 8 weeks after the intervention. For statistical analysis, independent t-test and paired t-test were used. Results: The comparison of self-efficacy between the exercise group and control group after 8 weeks of intervention showed a significant difference between the groups in terms of the CDSES (F1,43= 22.92, p < 0.001) and ESES (F1,38= 10.84, p < 0.001) results. Moreover, the comparison of mean distance walked based on the 6MWT showed significant changes in this variable (F1= 2.05, p = 0.015). Conclusions: The designed exercise program can improve self-efficacy and physical performance in hemodialysis patients. This intervention is recommended for hemodialysis patients due to its effectiveness, simplicity, and uncomplicated characteristics
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Affiliation(s)
- Marzieh Hatef
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nouraddin Mousavinasab
- Department of Biostatistics, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ravanbakhsh Esmaeili
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahsa Kamali
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Madani
- Department of Sport Medicine, Mazandaran University Medical Science, Sari, Iran
| | - Fatemeh Spahbodi
- Department of Nephrology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Vida Shafipour
- Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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14
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Salhab N, Alrukhaimi M, Kooman J, Fiaccadori E, Aljubori H, Rizk R, Karavetian M. Effect of Intradialytic Exercise on Hyperphosphatemia and Malnutrition. Nutrients 2019; 11:nu11102464. [PMID: 31618888 PMCID: PMC6836201 DOI: 10.3390/nu11102464] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/03/2019] [Accepted: 10/12/2019] [Indexed: 12/16/2022] Open
Abstract
Intradialytic exercise (IDE) is not routinely prescribed in hemodialysis (HD) units despite its potential benefits on patients' outcomes. This study was the first in the United Arab Emirates to examine the effect of aerobic IDE on hyperphosphatemia, malnutrition, and other health outcomes among HD patients. Participants were chosen from the largest HD unit in Sharjah Emirate for a quasi-experimental intervention with pre and post evaluation. The study lasted for 12 months. Study parameters were collected at baseline, post intervention, and follow-up. The intervention included a moderate-intensity aerobic IDE of 45 min per HD session; intensity was assessed using the Borg Scale. Patients were educated on the importance of exercise. Study outcomes were serum phosphorus (P), malnutrition inflammation score (MIS), quality of life (QOL), and pertinent blood tests. Forty-one eligible consenting HD patients were included in the study. Results at follow-up showed a non-significant reduction in P (p = 0.06) in patients who were hyperphosphatemic at baseline, but not in the sample as whole. MIS did not deteriorate throughout the study (p = 0.97). IDE resulted in a non-significant increase in the QOL visual analogue scale (p = 0.34). To conclude, aerobic IDE for 45 min is safe and could be beneficial, especially for hyperphosphatemic patients.
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Affiliation(s)
- Nada Salhab
- School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands.
| | - Mona Alrukhaimi
- Department of Medicine, Dubai Medical College, P.O. Box 22331, Dubai, UAE.
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, 6202 AZ Maastricht, The Netherlands.
| | - Enrico Fiaccadori
- Medicine and Surgery Department, Parma University Medical School, Via Gramsci 14, 43100 Parma, Italy.
| | - Harith Aljubori
- Department of Nephrology, Al Qassimi Hospital, P.O. Box 3500, Sharjah, UAE.
| | - Rana Rizk
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie, (INSPECT-LB) Beirut, Lebanon and Maastricht University, Faculty of Health Medicine and Life Sciences, 6200 MD Maastricht, The Netherlands.
| | - Mirey Karavetian
- Department of Health Sciences, College of Natural Health Sciences, Zayed University, P.O. Box 19282, Dubai, UAE.
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15
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Jamshidpour B, Bahrpeyma F, Khatami MR. The effect of aerobic and resistance exercise training on the health related quality of life, physical function, and muscle strength among hemodialysis patients with Type 2 diabetes. J Bodyw Mov Ther 2019; 24:98-103. [PMID: 32507160 DOI: 10.1016/j.jbmt.2019.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 10/02/2019] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Diabetic patients who undergo hemodialysis commonly suffer from reduction of both exercise capacity and muscle strength. These factors may have a negative effect on health related quality of life (HRQoL) and physical function. We investigated the effect of aerobic and resistance exercise training on the HRQoL, physical function, and muscle strength among hemodialysis patients with Type 2 diabetes. METHODS Twenty-eight diabetic patients who were on hemodialysis in the Milad Hospital (Tehran, Iran) were recruited for the study. Subjects were randomized into control (n = 13) and exercise training groups (n = 15). The exercise training group performed combined aerobic and resistance exercise training at moderate intensity (11-15/20 on the Borg scale) during hemodialysis treatment, 3 times a week for 8 weeks. The primary outcomes consisted of physical function measured by a 6-min walk test (6MWT), HR-QoL measured by the Short Form Health Survey (SF-36), and lower limb muscle strength measured using a hand-held Digital Dynamometer. RESULTS The 6MWT distance increased significantly in the exercise training group (36%). Bilateral hip flexor strength (right, 24.5%; left, 30.4%) and abductor strength (right, 27.6%; left, 25.2%) decreased significantly in the non-exercising control group but no significant change was found in the exercise group (P > 0.05). There were no significant changes in any of the 8 generic subscales of HR-QoL neither in the exercise training group nor controls following an 8- week study. CONCLUSIONS 8 weeks of combined aerobic-resistance exercise training among diabetic hemodialysis patients seem to be effective in improvement of physical function and lower limb muscle strength.
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Affiliation(s)
- Boshra Jamshidpour
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Farid Bahrpeyma
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
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16
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Zhou Y, Hellberg M, Svensson P, Höglund P, Clyne N. Sarcopenia and relationships between muscle mass, measured glomerular filtration rate and physical function in patients with chronic kidney disease stages 3-5. Nephrol Dial Transplant 2019; 33:342-348. [PMID: 28340152 DOI: 10.1093/ndt/gfw466] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/20/2016] [Indexed: 12/23/2022] Open
Abstract
Background Sarcopenia and poor physical function are common in patients with chronic kidney disease (CKD). Our aim was to investigate the relationships between muscle mass and measured glomerular filtration rate (GFR) and between muscle mass and strength and balance, respectively, in patients with CKD stages 3-5. Methods This is a baseline data analysis of a randomized controlled clinical trial. A total of 148 adult patients with an estimated GFR <30 mL/min/1.72 m2, not on renal replacement therapy, irrespective of the number of comorbidities were included from the Department of Nephrology, Skåne University Hospital, Lund, from 2011 to 2016. Body composition was measured by dual-energy X-ray absorptiometry (DEXA). GFR was measured by iohexol clearance. Balance was measured by functional reach and the Berg balance test and strength by handgrip strength and isometric quadriceps strength. Results Measured GFR ranged from 8 to 55 mL/min/1.73 m2. Lean mass (P < 0.05), fat mass (P < 0.05), appendicular skeletal muscle (P < 0.001) and appendicular skeletal muscle index (P < 0.05) were associated with GFR. Functional reach was associated with leg lean mass (P < 0.05) and the Berg balance test score was associated with trunk lean mass (P < 0.05). Handgrip strength was associated with arm lean mass (P < 0.001). Isometric quadriceps strength was associated with leg lean mass (P < 0.001). More men (44%) suffered from low muscle mass than women (22%), whereas more women (36%) suffered from low muscle strength than men (26%). However, when combining both, men (16%) suffered from sarcopenia to a greater extent than women (8%). Conclusions Among patients with CKD stages 3-5, loss of lean body mass, especially appendicular skeletal muscle, was significantly related to GFR decline. Two important markers of physical function, balance and strength, were significantly related to muscle mass. Moreover, men were more prone to sarcopenia than women during kidney function decline.
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Affiliation(s)
- Yunan Zhou
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Nephrology, Lund, Sweden
| | - Matthias Hellberg
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Nephrology, Lund, Sweden
| | - Philippa Svensson
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Nephrology, Lund, Sweden
| | - Peter Höglund
- Lund University, Skåne University Hospital, Department of Laboratory Medicine, Division of Clinical Chemistry & Pharmacology, Lund, Sweden
| | - Naomi Clyne
- Lund University, Skåne University Hospital, Department of Clinical Sciences, Division of Nephrology, Lund, Sweden
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17
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Cops J, Haesen S, De Moor B, Mullens W, Hansen D. Exercise intervention in hospitalized heart failure patients, with emphasis on congestion-related complications: a review. Heart Fail Rev 2019; 25:257-268. [DOI: 10.1007/s10741-019-09833-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Song P, Wang M, Chang X, Wang J, Wei W, An L. Prevalence and associated factors of impaired renal function in Chinese children: The China Health and Nutrition Survey. Nephrology (Carlton) 2019; 24:195-201. [PMID: 28990702 PMCID: PMC5891388 DOI: 10.1111/nep.13178] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2017] [Indexed: 11/29/2022]
Abstract
AIM To assess the prevalence of impaired renal function and its associated factors in Chinese children. METHODS Children aged 7-18 years in China Health and Nutrition Survey (CHNS) 2009 were included as participants, and their anthropometric measurements, blood pressure (BP) and biochemical parameters were taken for analysis. The estimated glomerular filtration rate (eGFR) was calculated by using the Schwartz 'original' formula. RESULTS The prevalence of estimated glomerular filtration rate (eGFR) < 90 mL/min per 1.73 m2 and <75 mL/min per 1.73 m2 was 10.09% (95% CI: 8.03-12.11) and 1.01% (95% CI: 0.38-1.77), respectively. The prevalence of impaired renal function (eGFR <60 mL/min per 1.73 m2 ) was 0.25%. Age was detected as a negative associated factor whereas hyperuricemia and elevated total cholesterol (TC) were positively associated factors for subjects with eGFR <90 mL/min per 1.73 m2 . In the group of eGFR <75 mL/min per 1.73 m2 , only elevated TC was related to the increased odds of decreased eGFR. CONCLUSION Our findings underscore the need for large-scale programs to detect and treat the early-stage impaired renal function in the paediatric population in China.
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Affiliation(s)
- Peige Song
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK
| | - Manli Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xinlei Chang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
| | - Jiawen Wang
- Institute of Medical Humanities, Peking University, Beijing 100191, China
| | - Wei Wei
- Institute of Medical Humanities, Peking University, Beijing 100191, China
| | - Lin An
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
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19
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Salhab N, Karavetian M, Kooman J, Fiaccadori E, El Khoury CF. Effects of intradialytic aerobic exercise on hemodialysis patients: a systematic review and meta-analysis. J Nephrol 2019; 32:549-566. [PMID: 30659520 PMCID: PMC6588711 DOI: 10.1007/s40620-018-00565-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/19/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Intradialytic exercise (IDE) is not yet a routine practice for hemodialysis patients, the lack of guidelines supporting it being a major reason. This systematic review and meta-analysis of aerobic IDE interventions examined the efficacy of IDE regarding quality of life (QOL), serum phosphorus, dialysis efficiency, inflammatory status, vitamin D3, parathyroid hormone, intake of phosphate binders, mortality and hospitalization rate. METHODS Pubmed, Medline (Ovid), Embase (Ovid), Cochrane, and Cinahl (EBSCO) databases were searched to retrieve studies up to June 12, 2018. A manual reference search was also performed. Studies were included if they evaluated (a) aerobic IDE effect on at least one of our study parameters, (b) adult hemodialysis patients, (c) patients for > 1 month. RESULTS Twenty-two studies were retrieved (706 participants), of which 12 were eligible for meta-analysis. Aerobic IDE had a significant positive effect on the QOL physical component score (QOL-PSC) and on mental component score (QOL-MCS) of SF36, but not on serum phosphorus or Kt/V. CONCLUSIONS IDE incorporation into clinical practice has a significant positive effect on QOL-PSC and QOL-MCS. In the reviewed studies, IDE did not result in any health hazard in hemodialysis patients. Nevertheless, future research should assess the long-term effectiveness and safety of IDE. The limitations of this review include the lack of quality analysis of the studies, the limited number of studies that could be included in the meta-analysis, the diversity in the exercise intensity, duration and modality, and the limited data for several outcomes. PROSPERO REGISTRATION ID CRD42016052062.
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Affiliation(s)
- Nada Salhab
- School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Mirey Karavetian
- Department of Health Sciences, College of Natural Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Jeroen Kooman
- Department of Internal Medicine, Division of Nephrology, University Hospital Maastricht, Maastricht, The Netherlands
| | - Enrico Fiaccadori
- Internal Medicine and Nephrology Department, Parma University Medical School, Parma, Italy
| | - Cosette F El Khoury
- School of Public Health and Primary Care, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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20
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Oliveira ACFD, Vieira DSR, Bündchen DC. Nível de atividade física e capacidade funcional de pacientes com doença renal crônica pré-dialítica e em hemodiálise. FISIOTERAPIA E PESQUISA 2018. [DOI: 10.1590/1809-2950/18003625032018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi comparar a capacidade funcional (CF) e o nível de atividade física (NAF) de indivíduos com doença renal crônica (DRC) em tratamento hemodialítico (HD) em longo prazo (G1); em curto prazo (G2); em tratamento conservador (G3) e indivíduos sem DRC (G4). Trata-se de um estudo transversal, descritivo, composto por uma amostra de conveniência. Foram avaliados 44 indivíduos, sendo 13 do G1 (50,6±11,5 anos), 9 do G2 (50,8±19,01), 9 do G3 (42,8±15,6) e 13 do G4 (49,2±11,2). A CF foi avaliada pelo teste de caminhada de seis minutos (TC6´), e o nível de atividade física pelo questionário IPAQ. Para a análise estatística na comparação entre grupos utilizou-se o Anova One-way com post hoc de Bonferroni. Para variáveis categóricas foi utilizado o teste de qui-quadrado. Foi encontrada diferença significativa na comparação da distância percorrida no TC6’ entre G1 e G4 (409,4±108,1 x 571,9±31,5m; p=0,001) e entre G2 e G4 (422,6±133,2 x 571,9±31,5m; p=0,006). O mesmo ocorreu para valores da distância percorrida no TC6’ em percentual do previsto. Quanto ao NAF, não foram encontradas diferenças significativas entre os grupos, e a maioria dos indivíduos apresentou baixo NAF. Dessa forma, conclui-se que indivíduos com DRC que realizam HD apresentam redução da CF quando comparados a pessoas sem DRC.
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21
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Lemes ÍR, Turi-Lynch BC, Cavero-Redondo I, Linares SN, Monteiro HL. Aerobic training reduces blood pressure and waist circumference and increases HDL-c in metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. ACTA ACUST UNITED AC 2018; 12:580-588. [DOI: 10.1016/j.jash.2018.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/06/2018] [Accepted: 06/13/2018] [Indexed: 02/06/2023]
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22
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Meremo AJ, Masalu MB, Sabi I, Ngilangwa DP, Kapinga J, Tagalile R, Munyogwa MJ, Mwashambwa MY. Prevalence and Risk Factors Associated With Chronic Kidney Disease Among Patients Presenting at a Haemodialysis Unit in Dodoma, Tanzania. East Afr Health Res J 2018; 2:53-57. [PMID: 34308175 PMCID: PMC8279169 DOI: 10.24248/eahrj-d-16-00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/19/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a major public health problem worldwide, due to its epidemic proportions and the associated cardiovascular morbidity and mortality. However, data on the burden of CKD among patients attending hospitals in Tanzania are still limited. The aim of this study was to determine the prevalence and risk factors associated with CKD among patients presenting at the University of Dodoma (UDOM) haemodialysis unit in Tanzania. METHODS In this retrospective study, we reviewed data of 1,395 patients who presented at the UDOM haemodialysis unit from January 2013 to June 2015. Data were descriptively and inferentially analysed using Stata version 11.0. RESULTS From January 2013 to June 2015, a total of 1,395 patients presented at the UDOM haemodialysis unit with history of kidney disease. Of these patients, 1244 (89.2%) enrolled into this study, 651 (52.3%) of them were female. Almost two-thirds (n=792, 63.7%) of the patients were found to have CKD, 59.1% with an estimated glomerular filtration rate of <60 mL/min/1.73 m2. Among those who had CKD, 347 (43.8%) had hypertension, 241 (30.4%) had diabetic mellitus, 79 (10.0%) had chronic glomerulonephritis, 70 (8.8%) had hypertension and diabetes mellitus, 38 (4.8%) had HIV/AIDS, and 17 (2.1%) had hepatitis B. The median serum creatinine level was 222 lmol/L (interquartile range [IQR] 126 to 317), urea level was 14.5 mmol/L (IQR 5 to 24), hemoglobin was 11.0 g/dL (IQR 6.2 to 15.7), and body mass index was 27.1 kg/m2 (IQR 17.3 to 36.8). Obesity, diabetes mellitus, and systolic hypertension were associated with developing CKD (P<.001). A total of 116 patients received haemodialysis during the study period. CONCLUSION CKD was common among patients presenting in our hospital and is associated with high cardiovascular risk. To that end, patients should be thoroughly evaluated to identify and correct causes of their kidney disease, and efforts should be put in place for early detection and screening as well as advocacy on risk factors for CKD development in Tanzania.
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Affiliation(s)
- Alfred J Meremo
- School of Medicine and Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | - Matobogolo B Masalu
- School of Medicine and Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
- Haemodialysis Unit, The University of Dodoma, Dodoma, Tanzania
| | - Issa Sabi
- National Institute for Medical Research, Mbeya Medical Research Centre, Mbeya, Tanzania
| | | | - Janet Kapinga
- Haemodialysis Unit, The University of Dodoma, Dodoma, Tanzania
| | - Rehema Tagalile
- Haemodialysis Unit, The University of Dodoma, Dodoma, Tanzania
| | - Mariam J Munyogwa
- School of Medicine and Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
| | - Masumbuko Y Mwashambwa
- School of Medicine and Dentistry, College of Health Sciences, The University of Dodoma, Dodoma, Tanzania
- Haemodialysis Unit, The University of Dodoma, Dodoma, Tanzania
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Afsar B, Siriopol D, Aslan G, Eren OC, Dagel T, Kilic U, Kanbay A, Burlacu A, Covic A, Kanbay M. The impact of exercise on physical function, cardiovascular outcomes and quality of life in chronic kidney disease patients: a systematic review. Int Urol Nephrol 2018; 50:885-904. [DOI: 10.1007/s11255-018-1790-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/07/2018] [Indexed: 12/18/2022]
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24
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Broers NJH, Martens RJH, Cornelis T, van der Sande FM, Diederen NMP, Hermans MMH, Wirtz JJJM, Stifft F, Konings CJAM, Dejagere T, Canaud B, Wabel P, Leunissen KML, Kooman JP. Physical Activity in End-Stage Renal Disease Patients: The Effects of Starting Dialysis in the First 6 Months after the Transition Period. Nephron Clin Pract 2017; 137:47-56. [PMID: 28591752 DOI: 10.1159/000476072] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 04/25/2017] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Physical inactivity in end-stage renal disease (ESRD) patients is associated with increased mortality, and might be related to abnormalities in body composition (BC) and physical performance. It is uncertain to what extent starting dialysis influences the effects of ESRD on physical activity (PA). This study aimed to compare PA and physical performance between stage 5 chronic kidney disease (CKD-5) non-dialysis and dialysis patients, and healthy controls, to assess alterations in PA during the transition from CKD-5 non-dialysis to dialysis, and to relate PA to BC. METHODS For the cross-sectional analyses 44 CKD-5 non-dialysis patients, 29 dialysis patients, and 20 healthy controls were included. PA was measured by the SenseWear™ pro3. Also, the walking speed and handgrip strength (HGS) were measured. BC was measured by the Body Composition Monitor©. Longitudinally, these parameters were assessed in 42 CKD-5 non-dialysis patients (who were also part of the cross-sectional analysis), before the start of dialysis and 6 months thereafter. RESULTS PA was significantly lower in CKD-5 non-dialysis patients as compared to that in healthy controls but not as compared to that in dialysis patients. HGS was significantly lower in dialysis patients as compared to that in healthy controls. Walking speed was significantly lower in CKD-5 non-dialysis patients as compared to that in healthy controls but not as compared to that in dialysis patients. Six months after starting dialysis, activity related energy expenditure (AEE) and walking speed significantly increased. CONCLUSIONS PA is already lower in CKD-5 non-dialysis patients as compared to that in healthy controls and does not differ from that of dialysis patients. However, the transition phase from CKD-5 non-dialysis to dialysis is associated only with a modest improvement in AEE.
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25
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Chigira Y, Oda T, Izumi M, Yoshimura T. Effects of exercise therapy during dialysis for elderly patients undergoing maintenance dialysis. J Phys Ther Sci 2017; 29:20-23. [PMID: 28210031 PMCID: PMC5300797 DOI: 10.1589/jpts.29.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/14/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] Exercise therapy during dialysis is currently being recommended since it is easy for patients to follow and results in high participation rates. In this study, this therapy was performed for elderly patients undergoing maintenance dialysis, and its effects were examined. [Subjects and Methods] Seven elderly patients (age: 70.6 ± 4.4) with chronic renal failure, who were able to perform exercises during maintenance dialysis, received the exercise therapy 2 or 3 times weekly for 3 months. Lower-limb muscle strength as well as the standardized dialysis dose (Kt/V) was measured before and after intervention. The patients were also evaluated using the 30-sec chair stand test (CS-30), the World Health Organization QOL Assessment 26 (WHO-QOL26), and a questionnaire. [Results] The lower-limb muscle strength and circumference, CS-30 score, and Kt/V values improved after intervention, but the difference was not significant. Significant differences were observed only in the WHO-QOL26 score. [Conclusion] The outcome was particularly favorable in terms of the quality of life (QOL). Based on the results from the questionnaire, the higher QOL may be due to the patients' development of a positive attitude toward these activities. Although there were no significant differences, the values for the other criteria also improved, thereby supporting the effectiveness of exercise therapy to maintain or improve the patients' motor functions and activity daily living (ADL) ability.
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Affiliation(s)
- Yusuke Chigira
- Department of Physical Therapy, Faculty of Health Science, Takasaki University of Health and Welfare, Japan
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26
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Gullick J, Monaro S, Stewart G. Compartmentalising time and space: a phenomenological interpretation of the temporal experience of commencing haemodialysis. J Clin Nurs 2017; 26:3382-3395. [PMID: 28001331 DOI: 10.1111/jocn.13697] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2016] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To interpret the spatio-temporal experience of people with end-stage kidney disease and their families in the first months of haemodialysis. BACKGROUND While dialysis is the mainstay of end-stage kidney disease management, the actual initiation of treatment is often unexpected by people and families. Poor biopsychosocial preparation means haemodialysis commencement is experienced as a crisis. While previous phenomenological studies suggest that over time, a habitual incorporation of dialysis into one's self-concept is possible, the spatio-temporal experience of people new to haemodialysis is not well understood. DESIGN A phenomenological study. METHODS Following purposive sampling, 18 participants were recruited either during an inpatient admission or while attending a public hospital-based haemodialysis unit in Sydney, Australia. Eleven people who had commenced haemodialysis within the previous three months and five close family members were separately engaged in semistructured interviews. Hermeneutic interpretation within a Heideggerian framework occurred through a backward-and-forward analysis between the early haemodialysis experience and its relationship to Being. RESULTS Themes that related to a temporal and spatial understanding of Being-in-the-world as a new haemodialysis patient or carer included the following: 'compartmentalising life into dialysis and non-dialysis days' (lost time, clock time and lived time); 'compartmentalising before, now and future' (normalising the 'before', dealing with the 'now' and the 'foreverness' of dialysis); and finally, 'compartmentalising space'. CONCLUSIONS In the months after dialysis commencement, patients and family carers compartmentalise time and space with a loss of continuity of meaningful, lived time that had framed people's past sense of normal. RELEVANCE TO CLINICAL PRACTICE Resource enhancement activities should focus on social connectivity and provision of personnel and/or infrastructure to reduce boredom, to facilitate engagement with meaningful tasks and, where appropriate, to support the continuation of work activities during the dialysis period.
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Affiliation(s)
- Janice Gullick
- Sydney Nursing School, University of Sydney, Camperdown, NSW, Australia.,Sydney Local Health District, Concord West, NSW, Australia
| | - Susan Monaro
- Sydney Nursing School, University of Sydney, Camperdown, NSW, Australia.,Concord Repatriation General Hospital, Concord West, NSW, Australia
| | - Glenn Stewart
- Concord Repatriation General Hospital, Concord West, NSW, Australia
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27
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Esteve V, Carneiro J, Moreno F, Fulquet M, Garriga S, Pou M, Duarte V, Saurina A, Tapia I, Ramírez de Arellano M. Efecto de la electroestimulación neuromuscular sobre la fuerza muscular, capacidad funcional y composición corporal en los pacientes en hemodiálisis. Nefrologia 2017; 37:68-77. [DOI: 10.1016/j.nefro.2016.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 04/08/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022] Open
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28
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Fonseca NT, Urbano JJ, Nacif SR, Silva AS, Peixoto RAO, Urbano GJ, Oliveira EF, Santos IR, Oliveira CS, Insalaco G, Oliveira LVF. A systematic review of sleep disorders in patients with chronic kidney disease undergoing hemodialysis. J Phys Ther Sci 2016; 28:2164-70. [PMID: 27512289 PMCID: PMC4968529 DOI: 10.1589/jpts.28.2164] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/07/2016] [Indexed: 12/19/2022] Open
Abstract
The purpose of this study was to conduct a systematic review of the available evidence on
sleep disorders in patients with end stage renal disease (ESRD) undergoing hemodialysis
(HD). [Subjects and Methods] Two independent reviewers performed a computer-assisted
search of the MEDLINE, SciELO, LILACS, and BIREME Virtual Health Library medical databases
from their inception to November 2015. [Results] One thousand one hundred twenty-six
articles were found that met the inclusion criteria. Articles were excluded if they were
not in English, the patients did not undergo HD, or the studies were not cross-sectional
or clinical trials. After reading the full text, a further 300 studies were excluded
because they did not use polysomnography. The remaining 18 studies with ESRD patients
undergoing HD comprised 8 clinical trials and 10 cross-sectional studies. This systematic
review followed the criteria outlined by the PRISMA declaration. [Conclusion] In this
systematic review, a high prevalence of sleep disorders was observed in ESRD, including
sleep-disordered breathing. This knowledge may enable health professionals to devise new
strategies for the diagnosis and treatment of these patients, in order to reduce morbidity
and mortality and improve their quality of life.
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Affiliation(s)
- Nina Teixeira Fonseca
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Jessica Julioti Urbano
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Sergio Roberto Nacif
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Anderson Soares Silva
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Roger Andre Oliveira Peixoto
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Giovanni Julioti Urbano
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Ezequiel Fernandes Oliveira
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Israel Reis Santos
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Claudia Santos Oliveira
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
| | - Giuseppe Insalaco
- Institute of Biomedicine and Molecular Immunology, National Research Council of Italy, Italy
| | - Luis Vicente Franco Oliveira
- Sleep Laboratory, Rehabilitation Sciences Master's and PhD Degree Program, Nove de Julho University, UNINOVE, Brazil
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Neto JRS, Figueiredo E Castro LM, Santos de Oliveira F, Silva AM, Maria Dos Reis L, Quirino APA, Dragosavac D, Kosour C. Comparison between two physiotherapy protocols for patients with chronic kidney disease on dialysis. J Phys Ther Sci 2016; 28:1644-50. [PMID: 27313390 PMCID: PMC4905929 DOI: 10.1589/jpts.28.1644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/06/2016] [Indexed: 12/02/2022] Open
Abstract
[Purpose] To compare the effects of two physiotherapy protocols for chronic kidney
disease patients on dialysis. [Subjects and Methods] This is a prospective, randomized
study, in chronic kidney disease patients 18 years of age or older on dialysis. Sessions
for each group (were conducted three times per week for a total of 10 sessions), during
hemodialysis. Respiratory muscle strength (maximal inspiratory and expiratory pressure),
peak expiratory flow, and peripheral muscle strength were evaluated. The study group
received motor and respiratory physiotherapy, and the control group received motor
physiotherapy alone. [Results] We observed a significant increase in the maximal
inspiratory pressure in the study group in the 5th and 10th sessions and in the maximal
expiratory pressure in the 1st session, peak flow in the 1st and 10th sessions, and
dynamometry in the 10th session. In the control group, there was a significant decrease in
maximal inspiratory pressure in the 5th and 10th sessions, and in maximal expiratory
pressure in the 10th session, peak flow in the 5th and 10th sessions, and dynamometry in
the 5th session. [Conclusion] Implementation of motor physiotherapy combined with
respiratory physiotherapy may have contributed to the improvement of the variables
analyzed in the study group.
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Affiliation(s)
| | | | | | | | | | | | - Desanka Dragosavac
- Division of Physiology and Metabology in Surgery, Department of Surgery, Medical Sciences Faculty, State University of Campinas, Brazil
| | - Carolina Kosour
- Nursing Department, Federal University of Alfenas, Alfenas-MG, Brazil; Division of Physiology and Metabology in Surgery, Department of Surgery, Medical Sciences Faculty, State University of Campinas, Brazil; Federal University of Alfenas (Unifal), Brazil
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30
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Shiota K, Hashimoto T. Promotion and support of physical activity in elderly patients on hemodialysis: a case study. J Phys Ther Sci 2016; 28:1378-83. [PMID: 27190487 PMCID: PMC4868247 DOI: 10.1589/jpts.28.1378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 12/23/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to ascertain the optimum strategy for implementing a
physical activity intervention in patients on hemodialysis by investigating the physical
characteristics of elderly patients on hemodialysis, and their attitude to physical
activity and level of daily activity. [Subjects] The Subject were 10 elderly patients on
hemodialysis. [Methods] They wore a physical activity monitor for 1 week. Data obtained
were analyzed for hemodialysis and non- hemodialysis days, and two-way analysis of
variance was used to compare the number of steps and activity levels. A questionnaire was
administered to investigate the stage of psychological preparedness for exercise and
attitudes toward/awareness of exercise. [Results] There was no significant difference in
the number of steps or exercise levels on hemodialysis and non- hemodialysis days.
However, on both types of days, subjects spent long periods not engaged in any activity.
Most of their activity was either inactivity or sedentary behavior. [Conclusion] Patients
on hemodialysis with low physical activity levels are considered to have poor physical
function and exercise tolerance. To maintain and improve the physical function of patients
on hemodialysis, it will be necessary to reduce their time spent in inactive, and
comprehensive care that covers psychosocial aspects should be provided to promote the
proactive improvement of physical activity and their attitudes to exercise.
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31
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Mutluay FK, Gunduz A, Tekeoglu A, Oguz S, Yeni SN. Health related quality of life in patients with epilepsy in Turkey. J Phys Ther Sci 2016; 28:240-5. [PMID: 26957766 PMCID: PMC4756012 DOI: 10.1589/jpts.28.240] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 10/16/2015] [Indexed: 01/22/2023] Open
Abstract
[Purpose] This study measured the quality of life in epilepsy and determined
associated demographic and clinical factors by means of the Short Form-36 health survey.
[Subjects and Methods] 124 consecutive epilepsy patients were enrolled and their
demographic variables and clinical characteristics recorded. The Short Form-36
questionnaire was completed independently by each participant. Short Form-36 dimensional
and composite scores were computed and scaled with data from an extensive survey of the
healthy population. [Results] Short Form-36 scores for physical dimensions were similar to
healthy values, but those for mental dimensions except for energy/vitality were remarkably
and significantly lower than normal. All Short Form-36 average scores for women were lower
than those for men and significantly so for mental health composite scores. Patients
responding well to treatment were aware of their improving health as measured by the
Change in Health score and had better dimensional scores than those with a poor response.
[Conclusion] Patients with epilepsy do not perceive impaired physical health status.
However, their mental health appears vulnerable, especially in women. Therefore, the major
burden in epilepsy is in the mental health category. A positive treatment response is also
an important determinant of the related quality of life measure.
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Affiliation(s)
- Fatma Karantay Mutluay
- Division of Physical Therapy and Rehabilitation, Faculty of Health Science, Istanbul Medipol University, Turkey
| | - Aysegul Gunduz
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
| | - Anıl Tekeoglu
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
| | - Semra Oguz
- Division of Physical Therapy and Rehabilitation, Faculty of Health Science, Marmara University, Turkey
| | - Seher Naz Yeni
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
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32
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Silva LC, Marinho PÉM. Knowledge among nephrologists about the importance of exercise in the intradialytic period. J Phys Ther Sci 2015; 27:2991-4. [PMID: 26504342 PMCID: PMC4616143 DOI: 10.1589/jpts.27.2991] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/24/2015] [Indexed: 11/25/2022] Open
Abstract
[Purpose] To assess knowledge among nephrologists at hemodialysis services about routine
intradialytic therapeutic exercise, in the city of Recife. [Subjects and Methods] A
cross-sectional study, consisting of 49 nephrologists working in public and/or private
hemodialysis services, who responded to a semi-structured questionnaire about their
academic background, medical residency, and knowledge about exercise during the
intradialytic period. [Results] About 56.3% practiced for more than 10 years as
nephrologists, 69.4% did not receive information about intradialytic physical exercise
while in residency, 81.6% considered intradialytic exercise to be important, and 53.0% did
not prescribe exercise during hemodialysis. About 61.2% consider the level of physical
activity among their patients to be poor. Nephrologists graduating within 2 years were 10
times more likely to prescribe exercise, compared to those with more than 2 years since
graduation. [Conclusion] Our study found that the nephrologists interviewed do not usually
prescribe intradialytic therapeutic exercise, despite understanding its importance as part
of the treatment process. It is necessary to update doctors about the importance of
exercise for patients during the intradialytic period, as well as to incorporate this
knowledge at the undergraduate level.
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