Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 5 , Pages 680-687, May 2006

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.

  • Trisha L. Parsons, PhD

      Affiliations

    • School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
    • ,
  • Edwin B. Toffelmire, MD

      Affiliations

    • Division of Nephrology, Kingston General Hospital, Kingston, ON, Canada
    • ,
  • Cheryl E. King-VanVlack, PhD

      Affiliations

    • School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
    • Corresponding Author InformationCorrespondence to Cheryl E. King-VanVlack, PhD, School of Rehabilitation Therapy, Louise D. Acton Bldg, Queen’s University, Kingston, ON K7L 3N6, 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.

Key Words:  Exercise , Hemodialysis , Quality of life , Rehabilitation , Urea

 

 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.Reprints are not available from the author.

PII: S0003-9993(06)00051-7

doi:10.1016/j.apmr.2005.12.044

Archives of Physical Medicine and Rehabilitation
Volume 87, Issue 5 , Pages 680-687, May 2006

Article Tools

* Image Usage & Resolution