Exercise Training During Hemodialysis Improves Dialysis Efficacy and Physical Performance
Presented in part to the Canadian Society of Nephrology, May 27–31, 2004, Toronto, ON, Canada; the Canadian Society of Nephrology, May 23–26, 2003, St. John’s, NL, Canada; the McGill Rehabilitation Graduate Student Research Colloquium, April 25, 2003, Montreal, QC, Canada; and the Centre for Studies in Primary Care, Queen’s University, February 27, 2003, Kingston, ON, Canada.
Abstract
Parsons TL, Toffelmire EB, King-VanVlack CE. Exercise training during hemodialysis improves dialysis efficacy and physical performance.
Objective
To determine the impact of a 20-week intradialytic exercise program, consisting of 60 minutes of cumulative duration, low-intensity exercise during the first 2 hours of dialysis, on dialysis efficacy, physical performance, and quality of life in self-care hemodialysis (HD) patients.
Design
One-group repeated measures.
Setting
Satellite HD units affiliated with a Canadian teaching hospital.
Participants
A convenience sample of 13 self-care HD patients who were stable on dialysis for a minimum of 6 months and were medically screened for significant cardiac, pulmonary, and/or musculoskeletal pathology that would preclude exercise.
Intervention
A 5-month intradialytic exercise program in which subjects exercised 3 times a week (cycle ergometer, mini-stepper) for 30 minutes in each of the first 2 hours of HD.
Main Outcome Measures
Dialysis efficacy (in single-pool model of urea kinetics [spKt/V]) was assessed prior to and at the end of each month of the exercise program. Physical function (6-minute walk test [6MWT]), and quality of life. (Kidney Disease Quality of Life–Short Form [KDQOL]) were determined at baseline and at weeks 10 and 20 of the exercise program.
Results
SpKt/V increased 11% at the end of the first month of the program (P<.05) and remained elevated for the duration of the program (18%–19%). Distance walked on the 6MWT increased by 14% at both weeks 10 and 20 (P<.05). No changes were noted in KDQOL scores.
Conclusions
A low-intensity intradialytic exercise program is a viable adjunctive therapy, which improves HD efficacy and physical function in HD patients.
aSchool of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
bDivision of Nephrology, Kingston General Hospital, Kingston, ON, Canada
Correspondence to Cheryl E. King-VanVlack, PhD, School of Rehabilitation Therapy, Louise D. Acton Bldg, Queen’s University, Kingston, ON K7L 3N6, Canada
Supported by the Kidney Foundation of Canada (Allied Health Doctoral Fellowship); Garfield Kelly Research and Development Fund, Queen’s University; and Bedal Foundation, Kingston General Hospital.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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