Malagoni Anna Maria, Catizone Luigi, Mandini Simona, Soffritti Silvia, Manfredini Roberto, Boari Benedetta, Russo Giorgia, Basaglia Nino, Zamboni Paolo, Manfredini Fabio
Vascular Diseases Center, University of Ferrara, Ferrara - Italy.
J Nephrol. 2008 Nov-Dec;21(6):871-8.
Exercise has positive psychophysical effects on dialysis patients, thus effective programs should be identified. We evaluated the effects of an original 6-month walking program on physical capacity, health-related quality of life (HRQL) and postdialysis fatigue (PDF).
Thirty-one dialysis patients (19 male, mean age 65 -/+ 11 years) were divided into exercise (group E; n=17) and control (group C; n=14) groups, and evaluated upon entry, after the 6-month program and 19 -/+ 3 months later. Outcome measures were 6-minute walking distance (6MWD), SF-36 scale scores, self-reported PDF and recovery time. E group was assigned 2 daily 10-minute home walking sessions on the nondialysis day at a speed 50% below maximal treadmill speed as determined and updated monthly at the hospital. C group: no exercise.
Twenty patients (13 from E, 7 from C) completed the study. The E group, unlike the C group, increased 6MWD (308 -/+ 105 m, to 351 -/+ 118 m, p=0.0007), and HRQL, significantly for bodily pain, physical role and mental health (p<0.05), decreased PDF and recovery time (p<0.05). At the follow-up, 15 patients were reevaluated (9 from E, 6 from C). The E group was still active and showed 6MWD similar to baseline, with a decline of 0.13 -/+ 1.72 m/mo. The C group decreased 6MWD (p=0.026) with a decline of 3.43 -/+ 3.2 m/mo. For both groups, HRQL, PDF and recovery time showed slight variations from baseline.
In dialysis patients, a 6-month exercise program prescribed at the hospital and performed at home improved physical capacity, HRQL and PDF symptoms. Patients maintained an active lifestyle after discharge and showed a slow functional decline over a 2-year period.
运动对透析患者有积极的心理生理影响，因此应确定有效的运动方案。我们评估了一项为期6个月的原创步行计划对身体能力、健康相关生活质量（HRQL）和透析后疲劳（PDF）的影响。
31名透析患者（19名男性，平均年龄65±11岁）被分为运动组（E组；n = 17）和对照组（C组；n = 14），在入组时、6个月计划结束后以及19±3个月后进行评估。观察指标为6分钟步行距离（6MWD）、SF - 36量表评分、自我报告的PDF和恢复时间。E组在非透析日每天进行2次10分钟的家庭步行，速度比在医院每月测定和更新的最大跑步机速度低50%。C组：不运动。
20名患者（13名来自E组，7名来自C组）完成了研究。与C组不同，E组的6MWD增加（从308±105米增加到351±118米，p = 0.0007），HRQL在身体疼痛、身体功能和心理健康方面显著改善（p < 0.05），PDF和恢复时间减少（p < 0.05）。在随访时，对15名患者进行了重新评估（9名来自E组，6名来自C组）。E组仍然保持运动，6MWD与基线相似，每月下降0.13±1.72米。C组的6MWD下降（p = 0.026），每月下降3.43±3.2米。两组的HRQL、PDF和恢复时间与基线相比均有轻微变化。
对于透析患者，在医院制定并在家中进行的为期6个月的运动计划可改善身体能力、HRQL和PDF症状。患者出院后保持积极的生活方式，在2年期间功能下降缓慢。
