Kidney Week

Abstract: SA-OR076

Effect of Intradialytic Exercise on Physical Performance and Echocardiographic Findings in Maintenance Hemodialysis Patients

Session Information

• Improving Dialysis Delivery and Patient Outcomes
  October 27, 2018 | Location: 2, San Diego Convention Center
  Abstract Time: 06:06 PM - 06:18 PM

Category: Dialysis

• 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Cho, Ji-Hyung, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea (the Republic of)

Ji-Hyung Cho, MD

• Kim, Jun Chul, CHA Gumi Medical Center, CHA University School of Medicine, Gumi, Korea (the Republic of)

Jun Chul Kim,

Background

Poor physical performance (PP) is frequently observed and related to a high risk of mortality, cardiovascular events, and hospitalizations in dialysis patients. We aimed to investigate the effect of intradialytic exercise (IDE) on PP and echocardiographic findings in maintenance hemodialysis (MHD) patients.

Methods

This study randomly assigned ambulatory MHD patients aged≥20 years on dialysis≥6 months, to 4 groups: aerobic exercise (AE), resistance exercise (RE), combination exercise (CE), and control. A stationary bike was used for AE at moderate intensity and a TheraBand^®/theraball for RE at vigorous intensity. A 12-week IDE program (3 times/week) was completed in the AE (n=11), RE (n=10), and CE (n=12) groups. The control group (n=13) received only warm-up stretching. At baseline and 12-week follow-up, a sit-to-stand for 30 seconds test (STS30), a 6-minute walk test (6-MWT), and echocardiography were performed in all patients.

Results

We observed significant increases in STS30 (times/30 s) and 6-MWT (meters) in the AE (18.7±5.4 vs 16.5±4.8 and 459±122 vs 434±111, respectively), RE (24.6±4.9 vs 21.0±5.0 and 530±106 vs 510±102, respectively), and CE (24.8±10.7 vs 21.6±9.6 and 514±165 vs 492±167, respectively) groups at 12 weeks compared with baseline, while no improvement was observed in the control group. When comparing between-group changes in STS30 and 6-MWT, there were significant increases in the AE (2.3±2.2 vs -0.5±2.2 and 25±29 vs -26±41, respectively), RE (3.6±2.7 vs -0.5±2.2 and 20±21 vs -26±41, respectively), and CE (3.3±3.1 vs -0.5±2.2 and 22±12 vs -26±41, respectively) groups compared with the control group. In the echocardiographic analysis, the 12-week IDE group interventions (AE, RE, and CE) showed no significant change on left ventricular (LV) ejection fraction (%) (2.5±5.2, -0.7±5.3, and -0.3±5.4 vs 0.3±3.9, respectively), LV mass index (g/m²) (-1.5±16.7, 0.8±16.3, and -0.5±32.0 vs -11.7±30.1, respectively), and myocardial performance index (0.09±0.19, -0.02±0.18, and 0.12±0.21 vs 0.08±0.18, respectively) compared with the control group.

Conclusion

Although IDE does not affect the echocardiographic parameters measured, it appears to be clinically beneficial in improving PP. It may suggest that IDE can also contribute to improve PP even before any significant benefits in cardiac function is achieved in MHD patients.