Frih Bechir, Jaafar Hamdi, Mkacher Wajdi, Ben Salah Zohra, Hammami Mohamed, Frih Ameur
Department of Biochemistry, Human Nutrition and Metabolic Disorders, Functional Foods and Vascular Health (LR12ES05), Faculty of Medicine of Monastir, University of MonastirMonastir, Tunisia.
Institut du Savoir Montfort-Recherche, Hôpital MontfortOttawa, ON, Canada.
Front Physiol. 2017 May 31;8:288. doi: 10.3389/fphys.2017.00288. eCollection 2017.
Tunisia has the highest prevalence of hemodialysis patients compared to the other countries in North Africa. Dialysis centers rarely offer an exercise program to prevent physiological and psychological dialysis therapy-related alterations in chronic hemodialysis patients. To examine the effect of combined endurance-resistance training program on physiological and psychological outcomes in patients undergoing hemodialysis. We designed a single blinded, randomized, controlled study for a period of 4 months. Patients were randomized to intervention group or control group. Intervention group patients received 4 training sessions per week, held on non-hemodialysis days for a period of 4 months, whereas control group patients continued their regular lifestyle practice without direct intervention from the personnel of this investigation. Patients were evaluated at baseline (initial assessment) and after the four-month study period (final assessment) by the same investigator blinded to treatment group assignment using physical, physiological, and psychological measurements. Compared with control group, intervention group showed significant improvement in physical performance during the sit-to-stand-to-sit tests (STS-10: -16.2%, ES = -1.65; STS-60: +23.43%, ES = 1.18), handgrip force task (+23.54%, ES = 1.16), timed up and go test (-13.86%, ES = -1.13), and 6-min walk test (+15.94%, ES = 2.09). Likewise, mini nutritional assessment long form scores after intervention period were significantly higher in the intervention group compared to the control group (ES = 1.43). Physical and mental component scores of SF-36 questionnaire increased significantly in the intervention group (ES = 1.10 and ES = 2.06, respectively), whereas hospital anxiety and depression scale scores decreased significantly (ES = -1.65 and ES = -2.72, respectively). Regarding biological parameters, intervention group displayed improvement in systolic and diastolic blood pressures (ES = -2.77 and ES = -0.87, respectively), HDL-cholesterol, LDL-cholesterol, and triglycerides systematic levels (ES = 1.15, ES = -0.98, and ES = -1.01, respectively); however no significant effect of intervention period was observed on C-reactive protein, hemoglobin, albumin, and total cholesterol levels ( > 0.05). The current study showed that combined endurance-resistance training program had a beneficial effect on physical capacity and quality of life in chronic hemodialysis patients.
与北非其他国家相比，突尼斯的血液透析患者患病率最高。透析中心很少为慢性血液透析患者提供运动项目，以预防与透析治疗相关的生理和心理改变。为了研究耐力-阻力联合训练计划对接受血液透析患者的生理和心理结局的影响。我们设计了一项为期4个月的单盲、随机、对照研究。患者被随机分为干预组或对照组。干预组患者每周接受4次训练课程，在非血液透析日进行，为期4个月，而对照组患者继续其正常生活方式，未受到本研究人员的直接干预。由对治疗组分配情况不知情的同一名研究人员在基线（初始评估）和4个月研究期结束后（最终评估），使用身体、生理和心理测量方法对患者进行评估。与对照组相比，干预组在坐立-坐立测试（STS-10：-16.2%，效应量= -1.65；STS-60：+23.43%，效应量= 1.18）、握力任务（+23.54%，效应量= 1.16）、计时起立行走测试（-13.86%，效应量= -1.13）和6分钟步行测试（+15.94%，效应量= 2.09）中的身体表现有显著改善。同样，干预组在干预期后的简易营养评估长表得分显著高于对照组（效应量= 1.43）。干预组SF-36问卷的身体和心理成分得分显著提高（效应量分别为1.10和2.06），而医院焦虑抑郁量表得分显著降低（效应量分别为-1.65和-2.72）。关于生物学参数，干预组的收缩压和舒张压有所改善（效应量分别为-2.77和-0.87），高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和甘油三酯的系统水平（效应量分别为1.15、-0.98和-1.01）；然而，干预期对C反应蛋白、血红蛋白、白蛋白和总胆固醇水平未观察到显著影响（P>0.05）。当前研究表明，耐力-阻力联合训练计划对慢性血液透析患者的身体能力和生活质量有有益影响。
