Konstantinidou Erasmia, Koukouvou Georgia, Kouidi Evangelia, Deligiannis Asterios, Tourkantonis Achilleas
Laboratory of Sports Medicine, Renal-Unit, Aristotle University of Thessaloniki, Greece.
J Rehabil Med. 2002 Jan;34(1):40-5. doi: 10.1080/165019702317242695.
Functional capacity of end-stage renal disease patients is dramatically impaired. Although exercise training programs appear to have beneficial morphological, functional and psychosocial effects in end-stage renal disease patients on hemodialysis (HD), the adherence rate is high. The purpose of this study was to compare the effects of three modes of exercise training on aerobic capacity and to identify the most favourable, efficient and preferable to patients on HD with regard to functional improvements and participation rate in the programs. Fifty-eight volunteer patients were screened for low-risk status and selected from the dialysis population. The 48 patients who completed the study protocol were randomly assigned either to one of the three training groups or to a control group. Sixteen of them (Group A - mean age 46.4+/-13.9 years) completed a 6-month supervised outpatient exercise renal rehabilitation program consisting of three weekly sessions of aerobic and strengthening training on the non-dialysis days; 10 (Group B - mean age 48.3+/-12.1 years) completed a 6-month exercise program during HD; 10 (Group C - mean age 51.4+/-12.5 years) followed an unsupervised moderate exercise program at home, and 12 patients (Group D-mean age 50.2+/-7.9 years) were used as patient controls. The level of anemia, the medications and the HD prescription remained stable during the study. Fifteen sex- and age-matched sedentary individuals (Group E - mean age 46.9+/-6.4 years) comprised a healthy control group for baseline data. All subjects at the beginning and end of the study underwent clinical examination, laboratory tests and a treadmill exercise test to fatigue endpoints with direct measurement of aerobic capacity. Group A had a higher dropout rate (24%) compared to groups B (17%) and C (17%). Peak oxygen consumption (VO2 peak) increased by 43% (p < 0.05), anaerobic threshold (VO2AT) by 37% (p < 0.05) and exercise time by 33% (p < 0.05) after training in Group A; by 24% (p < 0.05), 18% (p < 0.05) and 22% (p < 0.05), respectively, in B; and by 17% (p < 0.05), 8% (p < 0.05) and 14% (p < 0.05), respectively, in C; while both remained almost unchanged in Group D. These results demonstrate that intense exercise training on non-dialysis days is the most effective way of training, whereas exercise during HD is also effective and preferable.
终末期肾病患者的功能能力严重受损。尽管运动训练项目似乎对接受血液透析（HD）的终末期肾病患者具有有益的形态、功能和心理社会影响，但依从率很高。本研究的目的是比较三种运动训练模式对有氧运动能力的影响，并确定在功能改善和项目参与率方面对HD患者最有利、最有效且最受患者青睐的模式。对58名志愿者患者进行低风险状态筛查，并从透析人群中选取。完成研究方案的48名患者被随机分配到三个训练组之一或对照组。其中16人（A组 - 平均年龄46.4±13.9岁）完成了为期6个月的门诊监督下的运动肾脏康复项目，包括在非透析日每周进行三次有氧运动和强化训练；10人（B组 - 平均年龄48.3±12.1岁）在HD期间完成了为期6个月的运动项目；10人（C组 - 平均年龄51.4±12.5岁）在家中进行无监督的适度运动项目，12名患者（D组 - 平均年龄50.2±7.9岁）作为患者对照组。在研究期间，贫血水平、药物治疗和HD处方保持稳定。15名年龄和性别匹配的久坐不动个体（E组 - 平均年龄46.9±6.4岁）组成健康对照组以获取基线数据。所有受试者在研究开始和结束时均接受临床检查、实验室测试以及跑步机运动测试直至疲劳终点，直接测量有氧运动能力。与B组（17%）和C组（17%）相比，A组的退出率更高（24%）。训练后，A组的峰值耗氧量（VO2峰值）增加了43%（p < 0.05），无氧阈值（VO2AT）增加了37%（p < 0.05），运动时间增加了33%（p < 0.05）；B组分别增加了24%（p < 0.05）、%18（p < 0.05）和22%（p < 0.05）；C组分别增加了17%（p < 0.05）、8%（p < 0.05）和14%（p < 0.05）；而D组两者几乎没有变化。这些结果表明，在非透析日进行高强度运动训练是最有效的训练方式，而在HD期间进行运动也是有效的且更受青睐。
