Effect of Intradialytic Versus Home-Based Aerobic Exercise Training on Physical Function and Vascular Parameters in Hemodialysis Patients: A Randomized Pilot Study
Received 21 April 2009; accepted 14 September 2009. published online 23 November 2009.
Background
Hemodialysis patients show reduced physical function and greater risk of increased arterial stiffness because of hypertension, metabolic disturbances, and vascular calcification. Exercise interventions potentially could improve their vascular risk profile.
Study Design
Randomized controlled pilot clinical study comparing the effects of 6 months of supervised intradialytic exercise training versus home-based exercise training or usual care on physical function and arterial stiffness in hemodialysis patients.
Setting & Participants
70 hemodialysis patients from 3 renal units.
Intervention
Intradialytic-exercise patients trained 3 times/wk for 6 months on a cycle ergometer and home-based-exercise patients followed a walking program to achieve the same weekly physical activity. Usual-care patients received no specific intervention.
Outcomes & Measurements
Primary outcome measures were distance traveled during a 6-minute walk test and aortic pulse wave velocity. Secondary outcome measures included augmentation index (augmentation pressure as a percentage of central pulse pressure), peripheral (brachial) and central blood pressures (measured noninvasively using radial tonometry), physical activity, and self-reported physical functioning. Measurements were made at baseline and 6 months.
Results
At 6 months, there were no significant differences between changes in 6-minute walk test distance (intradialytic exercise, +14%; home-based exercise, +11%; usual care, +5%), pulse wave velocity (intradialytic exercise, −4%; home-based exercise, −2%; usual care, +5%), or any secondary outcome measure.
Limitations
Lack of medication data limited the analysis of vascular parameters in this study.
Conclusion
There were no differences between intradialytic or home-based exercise training and usual care for either physical function or vascular parameters.
1School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
2School of Human Movement Studies, The University of Queensland, St. Lucia, Queensland, Australia
3Renal Research Tasmania, Launceston General Hospital, Charles St. Launceston, Tasmania, Australia
4Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
5School of Medicine, University of Queensland, Brisbane, Queensland, Australia
6Menzies Research Institute, University of Tasmania, Hobart, Tasmania, Australia
Address correspondence to Andrew D. Williams, PhD, School of Human Life Sciences, University of Tasmania, Locked Bag 1320, Launceston, Tasmania, 7250 Australia
ABSTRACT