Doyle Arthur, Chalmers Karen, Chinn David J, McNeill Fiona, Dall Nicola, Grant Christopher H
Department of Renal Medicine, Victoria Hospital, Hayfield Road, Kirkcaldy, UK.
NHS Fife Research and Development, Queen Margaret Hospital, Whitefield Road, Fife, UK.
Clin Kidney J. 2017 Dec;10(6):822-829. doi: 10.1093/ckj/sfx046. Epub 2017 Jun 27.
Exercise improves physical capacity in patients with end-stage renal disease on haemodialysis (HD), but few patients engage in it. Whole-body vibration exercise (WBVE) is a novel protocol that has been shown to benefit frail elderly patients' rehabilitation. We assessed the utility of WBVE before HD sessions and tested methods to inform the design of a randomized controlled trial (RCT).
Physical condition and quality of life were assessed at enrolment and repeated 2 weeks later in a pilot study of 49 patients undergoing regular HD. All patients then undertook 8 weeks of WBVE, thrice weekly for 3 min, after which the assessments were repeated and results compared (paired -tests). Further assessments were made after a 4-week layoff. Patients completed a post-study questionnaire about their experiences of using WBVE. The reproducibility of WBVE and effects on measures of functionality, muscle strength, indirect exercise capacity, nutritional status, bone health and quality of life were recorded to undertake a power calculation for an RCT.
Of 49 patients enrolled, 25 completed all assessments. The dropout rate was high at 49%, but overall, WBVE was an acceptable form of exercise. Functionality as assessed by the 60-s sit-to-stand test (STS-60) improved significantly by 11% (P = 0.002). Some quality of life domains also improved significantly. All improvements were maintained 4 weeks after discontinuing WBVE.
WBVE was acceptable, safe, easily incorporated into the routine of HD and was associated with useful improvements in physical function sufficient to justify a RCT.
运动可改善接受血液透析(HD)的终末期肾病患者的身体机能,但很少有患者进行运动。全身振动运动(WBVE)是一种新型运动方案,已被证明对体弱老年患者的康复有益。我们评估了HD治疗前WBVE的效用,并测试了相关方法,以为随机对照试验(RCT)的设计提供依据。
在一项针对49例接受常规HD治疗患者的初步研究中,在入组时评估身体状况和生活质量,并在2周后重复评估。然后,所有患者进行为期8周的WBVE,每周三次,每次3分钟,之后再次进行评估并比较结果(配对检验)。在中断4周后进行进一步评估。患者完成了一份关于使用WBVE体验的研究后问卷。记录WBVE的可重复性及其对功能、肌肉力量、间接运动能力、营养状况、骨骼健康和生活质量指标的影响,以便为RCT进行功效计算。
在入组的49例患者中,25例完成了所有评估。脱落率高达49%,但总体而言,WBVE是一种可接受的运动形式。通过60秒坐立试验(STS-60)评估的功能显著改善了11%(P = 0.002)。一些生活质量领域也有显著改善。停止WBVE 4周后,所有改善均得以维持。
WBVE是可接受的、安全的,易于纳入HD治疗常规,并且与身体功能的有益改善相关,足以证明进行RCT是合理的。