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居家有氧运动对超重慢性肾脏病患者身体机能的影响

Impact of home-based aerobic exercise on the physical capacity of overweight patients with chronic kidney disease.

作者信息

Aoike Danilo Takashi, Baria Flavia, Kamimura Maria Ayako, Ammirati Adriano, de Mello Marco Túlio, Cuppari Lilian

机构信息

Division of Nephrology, Federal University of São Paulo, Rua Pedro de Toledo, 282, São Paulo, SP, 04039-000, Brazil.

出版信息

Int Urol Nephrol. 2015 Feb;47(2):359-67. doi: 10.1007/s11255-014-0894-8. Epub 2014 Dec 11.

Abstract

BACKGROUND

Home-based exercise has been shown to provide benefits in terms of physical capacity in the general population, but has been scarcely investigated in patients with chronic kidney disease (CKD).

AIMS

To evaluate the impact of a home-based aerobic training on the cardiopulmonary and functional capacities of overweight non-dialysis-dependent patients with CKD (NDD-CKD).

METHODS

Twenty-nine sedentary patients (55.1 ± 11.6 years, BMI = 31.2 ± 6.1 kg/m(2), eGFR = 26.9 ± 17.4 mL/min/1.73 m(2)) were randomly assigned to a home-based exercise group (n = 14) or to a control group (n = 15) that remained without performing exercise. Aerobic training was performed three times per week for 12 weeks. A cardiopulmonary exercise test, functional capacity and clinical parameters were evaluated.

RESULTS

A significant increase, ranging from 8.3 to 17 %, was observed in the cardiopulmonary capacity parameters, such as maximal ventilation (p = 0.005), VO2peak (p = 0.049), ventilatory threshold (p = 0.040) and respiratory compensation point (p < 0.001), of the exercise group. A simultaneous improvement in the functional capacity tests [6-min walk test (p < 0.001), time up and go test (p < 0.001), arm curl test (p < 0.001), sit and stand test (p < 0.001), 2-min step test (p < 0.001) and back scratch test (p = 0.042)] was also found in patients who were submitted to the exercise. Exercised patients experienced a decrease in systolic and diastolic blood pressure, average 10.6 % (p < 0.001) and 9.2 % (p = 0.007), respectively, and a trend toward improved renal function (p = 0.1). No change in any parameter was found in the control group during the follow-up.

CONCLUSION

The home-based aerobic exercise program was feasible, safe and effective for the improvement in the cardiopulmonary and functional capacities of overweight NDD-CKD patients.

摘要

背景

居家锻炼已被证明对普通人群的身体能力有益,但在慢性肾脏病(CKD)患者中鲜有研究。

目的

评估居家有氧运动训练对超重的非透析依赖型CKD(NDD-CKD)患者心肺功能和身体功能的影响。

方法

29名久坐不动的患者(年龄55.1±11.6岁,体重指数=31.2±6.1kg/m²,估算肾小球滤过率=26.9±17.4mL/min/1.73m²)被随机分为居家锻炼组(n=14)或对照组(n=15),对照组不进行锻炼。有氧运动训练每周进行3次,共12周。评估心肺运动试验、身体功能和临床参数。

结果

锻炼组的心肺功能参数有显著提高,幅度在8.3%至17%之间,如最大通气量(p=0.005)、峰值摄氧量(p=0.049)、通气阈值(p=0.040)和呼吸补偿点(p<0.001)。接受锻炼的患者在身体功能测试[6分钟步行试验(p<0.001)、起立行走试验(p<0.001)、臂弯举试验(p<0.001)、坐立试验(p<0.001)、2分钟踏步试验(p<0.001)和背部抓挠试验(p=0.042)]中也同时得到改善。锻炼的患者收缩压和舒张压分别平均下降10.6%(p<0.001)和9.2%(p=0.007),且有肾功能改善的趋势(p=0.1)。随访期间对照组的任何参数均无变化。

结论

居家有氧运动计划对改善超重NDD-CKD患者的心肺功能和身体功能是可行、安全且有效的。

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