家庭锻炼对透析前慢性肾病患者的影响：一项随机试点及可行性试验。
Effects of home-based exercise on pre-dialysis chronic kidney disease patients: a randomized pilot and feasibility trial.
作者信息
Hiraki Koji, Shibagaki Yugo, Izawa Kazuhiro P, Hotta Chiharu, Wakamiya Akiko, Sakurada Tsutomu, Yasuda Takashi, Kimura Kenjiro
机构信息
Department of Rehabilitation Medicine, St. Marianna University School of Medicine Hospital, Kawasaki, Japan.
Division of Nephrology and Hypertension, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao Miyamae-ku, Kawasaki, Kanagawa, 216-8511, Japan.
出版信息
BMC Nephrol. 2017 Jun 17;18(1):198. doi: 10.1186/s12882-017-0613-7.
BACKGROUND
Only a few research is available on the effects of home-based exercise training on pre-dialysis chronic kidney disease (CKD) patients. Therefore, we aimed to elucidate the effect of home-based exercise therapy on kidney function and arm and leg muscle strength in pre-dialysis CKD patients.
METHODS
Thirty-six male stage 3-4 pre-dialysis CKD patients (age, 68.7 ± 6.8 years; estimated glomerular filtration rate (eGFR), 39.0 ± 11.6 ml/min/1.73 m) who were being treated as outpatients were included. The subjects were randomly assigned to an exercise intervention group (Ex group: 18) and a control group (C group: 18). The Ex group wore accelerometer pedometers and were instructed to perform home-based aerobic and resistance exercises, such as brisk walking for 30 min per day, for 12 months. The C group subjects wore accelerometer pedometers but received no exercise therapy guidance; the number of steps covered during normal daily activities was recorded for the C group. The outcome measures were changes in kidney function and handgrip and knee extension muscle strength. Values at the baseline (T1) and 12 months later (T2) were compared.
RESULTS
There were no significant differences in baseline characteristics between the two groups; however, the C group was more physically active than the Ex group. Eight subjects dropped out, and 28 subjects (14 in each group) were included in the final analysis. Physical activity increased significantly only in the Ex group. Grip strength (F = 7.0, p = 0.01) and knee extension muscle strength (F = 14.3, p < 0.01) were found to improve only in the Ex group. Further, the changes in eGFR were not significantly different between the two groups (F = 0.01, p = 0.93).
CONCLUSIONS
Home-based exercise therapy for pre-dialysis CKD patients was feasible and improved arm and leg muscle strength without affecting kidney function.
TRIAL REGISTRATION
UMIN Clinical Trials Registry ( UMIN000005091 ). Registered 2/15/2011.
背景
关于居家运动训练对透析前慢性肾脏病（CKD）患者影响的研究较少。因此，我们旨在阐明居家运动疗法对透析前CKD患者肾功能以及上肢和下肢肌肉力量的影响。
方法
纳入36例接受门诊治疗的男性3 - 4期透析前CKD患者（年龄68.7±6.8岁；估计肾小球滤过率（eGFR）39.0±11.6 ml/min/1.73 m²）。将受试者随机分为运动干预组（Ex组：18例）和对照组（C组：18例）。Ex组佩戴加速度计计步器，并被指导进行居家有氧运动和抗阻运动，如每天快走30分钟，持续12个月。C组受试者佩戴加速度计计步器，但未接受运动疗法指导；记录C组在日常正常活动中行走的步数。观察指标为肾功能、握力和膝关节伸展肌肉力量的变化。比较基线（T1）和12个月后（T2）的值。
结果
两组基线特征无显著差异；然而，C组的身体活动水平高于Ex组。8名受试者退出，最终分析纳入28名受试者（每组14名）。仅Ex组的身体活动显著增加。仅Ex组的握力（F = 7.0，p = 0.01）和膝关节伸展肌肉力量（F = 14.3，p < 0.01）有所改善。此外，两组间eGFR的变化无显著差异（F = 0.01，p = 0.93）。
结论
透析前CKD患者的居家运动疗法可行，可改善上肢和下肢肌肉力量，且不影响肾功能。
试验注册
UMIN临床试验注册中心（UMIN000005091）。2011年2月15日注册。
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