Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: A randomized pilot trial

Joline L.T. Chen, Susan Godfrey, Tan Tan Ng, Ranjani Moorthi, Orfeas Liangos, Robin Ruthazer, Bertrand L. Jaber, Andrew S. Levey, Carmen Castaneda-Sceppa

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Background. Kidney failure is associated with muscle wasting and physical impairment. Moderate-to high-intensity strength training improves physical performance, nutritional status and quality of life in people with chronic kidney disease and in dialysis patients. However, the effect of low-intensity strength training has not been well documented, thus representing the objective of this pilot study.Methods. Fifty participants (mean ± SD, age 69 ± 13 years) receiving long-term haemodialysis (3.7 ± 4.2 years) were randomized to intra-dialytic low-intensity strength training or stretching (attention-control) exercises twice weekly for a total of 48 exercise sessions. The primary study outcome was physical performance assessed by the Short Physical Performance Battery score (SPPB) after 36 sessions, if available, or carried forward from 24 sessions. Secondary outcomes included lower body strength, body composition and quality of life. Measurements were obtained at baseline and at completion of 24 (mid), 36 (post) and 48 (final) exercise sessions.Results. Baseline median (IQR) SPPB score was 6.0 (5.0), with 57% of the participants having SPPB scores below 7. Exercise adherence was 89 ± 15%. The primary outcome could be computed in 44 participants. SPPB improved in the strength training group compared to the attention-control group [21.1% (43.1%) vs. 0.2% (38.4%), respectively, P = 0.03]. Similarly, strength training participants exhibited significant improvements from baseline compared to the control group in knee extensor strength, leisure-time physical activity and self-reported physical function and activities of daily living (ADL) disability; all P < 0.02. Adverse events were common but not related to study participation.Conclusions. Intra-dialytic, low-intensity progressive strength training was safe and effective among maintenance dialysis patients. Further studies are needed to establish the generalizability of this strength training program in dialysis patients.

Original languageEnglish (US)
Pages (from-to)1936-1943
Number of pages8
JournalNephrology Dialysis Transplantation
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2010

Fingerprint

Resistance Training
Renal Dialysis
Exercise
Dialysis
Quality of Life
Control Groups
Leisure Activities
Nutritive Value
Activities of Daily Living
Body Composition
Nutritional Status
Chronic Renal Insufficiency
Renal Insufficiency
Knee
Maintenance
Outcome Assessment (Health Care)
Education
Muscles

Keywords

  • Haemodialysis
  • Older adults
  • Physical performance
  • Short Physical Performance Battery
  • Strength training

ASJC Scopus subject areas

  • Nephrology
  • Transplantation

Cite this

Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients : A randomized pilot trial. / Chen, Joline L.T.; Godfrey, Susan; Ng, Tan Tan; Moorthi, Ranjani; Liangos, Orfeas; Ruthazer, Robin; Jaber, Bertrand L.; Levey, Andrew S.; Castaneda-Sceppa, Carmen.

In: Nephrology Dialysis Transplantation, Vol. 25, No. 6, 01.06.2010, p. 1936-1943.

Research output: Contribution to journalArticle

Chen, Joline L.T. ; Godfrey, Susan ; Ng, Tan Tan ; Moorthi, Ranjani ; Liangos, Orfeas ; Ruthazer, Robin ; Jaber, Bertrand L. ; Levey, Andrew S. ; Castaneda-Sceppa, Carmen. / Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients : A randomized pilot trial. In: Nephrology Dialysis Transplantation. 2010 ; Vol. 25, No. 6. pp. 1936-1943.
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abstract = "Background. Kidney failure is associated with muscle wasting and physical impairment. Moderate-to high-intensity strength training improves physical performance, nutritional status and quality of life in people with chronic kidney disease and in dialysis patients. However, the effect of low-intensity strength training has not been well documented, thus representing the objective of this pilot study.Methods. Fifty participants (mean ± SD, age 69 ± 13 years) receiving long-term haemodialysis (3.7 ± 4.2 years) were randomized to intra-dialytic low-intensity strength training or stretching (attention-control) exercises twice weekly for a total of 48 exercise sessions. The primary study outcome was physical performance assessed by the Short Physical Performance Battery score (SPPB) after 36 sessions, if available, or carried forward from 24 sessions. Secondary outcomes included lower body strength, body composition and quality of life. Measurements were obtained at baseline and at completion of 24 (mid), 36 (post) and 48 (final) exercise sessions.Results. Baseline median (IQR) SPPB score was 6.0 (5.0), with 57{\%} of the participants having SPPB scores below 7. Exercise adherence was 89 ± 15{\%}. The primary outcome could be computed in 44 participants. SPPB improved in the strength training group compared to the attention-control group [21.1{\%} (43.1{\%}) vs. 0.2{\%} (38.4{\%}), respectively, P = 0.03]. Similarly, strength training participants exhibited significant improvements from baseline compared to the control group in knee extensor strength, leisure-time physical activity and self-reported physical function and activities of daily living (ADL) disability; all P < 0.02. Adverse events were common but not related to study participation.Conclusions. Intra-dialytic, low-intensity progressive strength training was safe and effective among maintenance dialysis patients. Further studies are needed to establish the generalizability of this strength training program in dialysis patients.",
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AU - Godfrey, Susan

AU - Ng, Tan Tan

AU - Moorthi, Ranjani

AU - Liangos, Orfeas

AU - Ruthazer, Robin

AU - Jaber, Bertrand L.

AU - Levey, Andrew S.

AU - Castaneda-Sceppa, Carmen

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N2 - Background. Kidney failure is associated with muscle wasting and physical impairment. Moderate-to high-intensity strength training improves physical performance, nutritional status and quality of life in people with chronic kidney disease and in dialysis patients. However, the effect of low-intensity strength training has not been well documented, thus representing the objective of this pilot study.Methods. Fifty participants (mean ± SD, age 69 ± 13 years) receiving long-term haemodialysis (3.7 ± 4.2 years) were randomized to intra-dialytic low-intensity strength training or stretching (attention-control) exercises twice weekly for a total of 48 exercise sessions. The primary study outcome was physical performance assessed by the Short Physical Performance Battery score (SPPB) after 36 sessions, if available, or carried forward from 24 sessions. Secondary outcomes included lower body strength, body composition and quality of life. Measurements were obtained at baseline and at completion of 24 (mid), 36 (post) and 48 (final) exercise sessions.Results. Baseline median (IQR) SPPB score was 6.0 (5.0), with 57% of the participants having SPPB scores below 7. Exercise adherence was 89 ± 15%. The primary outcome could be computed in 44 participants. SPPB improved in the strength training group compared to the attention-control group [21.1% (43.1%) vs. 0.2% (38.4%), respectively, P = 0.03]. Similarly, strength training participants exhibited significant improvements from baseline compared to the control group in knee extensor strength, leisure-time physical activity and self-reported physical function and activities of daily living (ADL) disability; all P < 0.02. Adverse events were common but not related to study participation.Conclusions. Intra-dialytic, low-intensity progressive strength training was safe and effective among maintenance dialysis patients. Further studies are needed to establish the generalizability of this strength training program in dialysis patients.

AB - Background. Kidney failure is associated with muscle wasting and physical impairment. Moderate-to high-intensity strength training improves physical performance, nutritional status and quality of life in people with chronic kidney disease and in dialysis patients. However, the effect of low-intensity strength training has not been well documented, thus representing the objective of this pilot study.Methods. Fifty participants (mean ± SD, age 69 ± 13 years) receiving long-term haemodialysis (3.7 ± 4.2 years) were randomized to intra-dialytic low-intensity strength training or stretching (attention-control) exercises twice weekly for a total of 48 exercise sessions. The primary study outcome was physical performance assessed by the Short Physical Performance Battery score (SPPB) after 36 sessions, if available, or carried forward from 24 sessions. Secondary outcomes included lower body strength, body composition and quality of life. Measurements were obtained at baseline and at completion of 24 (mid), 36 (post) and 48 (final) exercise sessions.Results. Baseline median (IQR) SPPB score was 6.0 (5.0), with 57% of the participants having SPPB scores below 7. Exercise adherence was 89 ± 15%. The primary outcome could be computed in 44 participants. SPPB improved in the strength training group compared to the attention-control group [21.1% (43.1%) vs. 0.2% (38.4%), respectively, P = 0.03]. Similarly, strength training participants exhibited significant improvements from baseline compared to the control group in knee extensor strength, leisure-time physical activity and self-reported physical function and activities of daily living (ADL) disability; all P < 0.02. Adverse events were common but not related to study participation.Conclusions. Intra-dialytic, low-intensity progressive strength training was safe and effective among maintenance dialysis patients. Further studies are needed to establish the generalizability of this strength training program in dialysis patients.

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KW - Older adults

KW - Physical performance

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