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Abstract: TH-PO623

Exercise with Blood Flow Restriction Is Safe and Tolerable and Enhances Strength Adaptations Among Dialysis Patients

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Clarkson, Matthew, Deakin University, Geelong, Victoria, Australia
  • Fraser, Steve F., Deakin University, Geelong, Victoria, Australia
  • Brumby, Catherine, Eastern Health, Melbourne, Victoria, Australia
  • Bennett, Paul N., Satellite Healthcare, San Jose, California, United States
  • McMahon, Lawrence P., Eastern Health, Melbourne, Victoria, Australia
  • Warmington, Stuart, Deakin University, Geelong, Victoria, Australia
Background

Haemodialysis (HD) patients have reduced exercise capacity, impaired muscle structure and function, and reduced exercise capacity. Intradialytic exercise interventions can improve subsequent declines in physical function associated with higher mortality with good adherence. Blood flow restriction (BFR) exercise enhances muscle strength and size adaptations to low-intensity exercise, thought to be insufficient for such adaptions. This technique appeals in ESKD but is yet to be evaluated in this population. The aim of this research was to assess haemodynamic safety and tolerability of BFR aerobic exercise in HD patients and the efficacy of a 6 week intervention.

Methods

In study 1, HD patients underwent a 3-phase program of supervised aerobic low-intensity exercise. Phase 1: 2 short bouts of cycling during 2 HD sessions. Phase 2: 2 short bouts of cycling with BFR whilst off HD on 2 separate days. Phase 3: 2 short bouts of cycling with BFR during 2 HD sessions. Participants with severe cardiovascular disease or known haemodynamic instability on HD were excluded. Outcome measures were haemodynamic (heart rate (HR) and blood pressure (BP)) and perceptual responses (exertion (RPE) and discomfort (RPD)) during exercise sessions. Study 2, a 6 week intervention, included a BFR group, undergoing 2 bouts of cycling with BFR during HD sessions, a non-BFR cycling group did 20 min continuous cycling during HD sessions, a usual care control group did no exercise. Outcomes included 3-rep maximum leg strength, and the 30-second sit-to-stand (30STS).

Results

There were increases in HR, systolic BP and mean arterial BP (P<0.05) post exercise for both exercise groups, with a delayed mean arterial BP reduction of 11.0 ± 1.3 mmHg (P<0.01). Adjusted for age and baseline, leg strength increased by 16±5% with BFR , compared with 9±5% in the non-BFR group, and no change in controls; 30STS increased only with BFR (P < 0.05). Across 452 sessions there were 6 minor adverse events, all episodes of self-resolving pre-syncope (4 after BFR exercise, 2 after non-BFR exercise).

Conclusion

Comparing BFR aerobic exercise to standard aerobic exercise during HD, haemodynamic safety and tolerability is comparable while strength and related physical function is increased with BFR aerobic exercise after 6 weeks exercise training.