Effects of intradialytic resistance training on physical activity in daily life, muscle strength, physical capacity and quality of life in hemodialysis patients: a randomized clinical trial

Abstract

Purpose: We evaluated the effects of supervised intradialytic resistance training on physical activity in daily life (PADL), muscle strength, physical capacity and quality of life (QoL) in hemodialysis patients.

Methods: Twenty-four hemodialysis patients were randomly assigned to either a 12-weeks moderate-intensity resistance training or a control period. An accelerometer evaluated PADL for seven consecutive days, measuring the time spent in different activities and positions of daily routine and the number of steps taken. Muscle strength, physical capacity and QoL were evaluated.

Results: After 12 weeks of training, we did not find significant difference (post-pre values) in walking time (−1.2 ± 18.3 vs. −9.2 ± 13.1 min/day); standing time (−10.2 ± 28.6 vs. 3.2 ± 20.1 min/day); sitting time (20.8 ± 58.9 vs. −30.0 ± 53.0 min/day); lying down time (−9.3 ± 57.9 vs. 34.6 ± 54.0 min/day); number of steps taken [−147 (1834) vs. −454 (2066)] and muscle strength in training and control group, respectively. There was a significant increase in the six-minute walking test distance (48.8 ± 35.9 vs. 6.9 ± 45.9 m, p < 0.05) and some domains of QoL in the training compared to the control group.

Conclusions: PADL was not modified after 12 weeks of intradialytic resistance training in hemodialysis patients. However, the exercise program was able to increase the physical capacity and some domains of QoL.

Implications for rehabilitation

• Physical activity in daily life was not modified after 12 weeks of intradialytic resistance training in hemodialysis patients.

• The exercise program was able to increase the physical capacity, efficacy of dialysis and some domains of quality of life in hemodialysis patients.

• The protocol used in this study was safe since no complications were observed during and after resistance training.

• These results should be interpreted with caution because we applied a moderate resistance training in both lower limbs and in the contralateral arteriovenous fistula upper limb, using perceived exertion by Borg scale to exercise prescription. Moreover, the safety protocol evaluation was not conducted.

Keywords:

• End-stage renal disease
• exercise capacity
• hemodialysis
• physical activity
• resistance exercise

Acknowledgements

The authors thank the nursing and medical staff at the Nephrology Unit of the Federal University of Juiz de Fora Hospital for their friendly support and the patients for their effort and enthusiastic cooperation throughout the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was supported by a Research Grant from Fundação de Amparo à Pesquisa do Estado de Minas Gerais – FAPEMIG (grant no. APQ 02371/15); and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.