Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA.
Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA,
Blood Purif. 2020;49(1-2):151-157. doi: 10.1159/000503772. Epub 2019 Dec 18.
Physical inactivity is prevalent and linked with a variety of unfavorable clinical outcomes in hemodialysis patients. To increase physical activity (PA) and improve quality of life in this population, intradialytic and out-of-clinic exercise interventions have been implemented in many studies. However, there is still a lack of consensus in the literature on which type of exercise intervention is more feasible and effective.
This review provides a brief overview of intradialytic and out-of-clinic exercise protocols utilized in previous studies. We also examine data related to the feasibility of each approach, and their efficacy for improving cardiovascular health, muscle mass, strength, and physical function. Key Messages: The benefits from most intradialytic and out-of-center exercise training interventions published to date have been modest or inconsistent. Furthermore, neither appears to provide a significant advantage over the other in terms of benefits for cardiovascular health, muscle mass, strength, and physical function. A significant concern is that most intradialytic and out-of-center exercise interventions are mandated exercise prescriptions that include either endurance or resistance training exercises, performed at low-moderate intensities, for a total of 60-135 min of exercise/week. This volume, intensity, and variety of exercise are far less than what is recommended in most PA guidelines. This type of structured activity is also boring for most patients. To enhance the effectiveness of exercise interventions, we suggest using the intradialytic period to provide patients guidance on how they can best incorporate more activity into their lives, based on their individual needs and barriers.
在血液透析患者中，体力活动不足很常见，且与多种不良临床结局相关。为了提高该人群的体力活动（PA）水平并改善其生活质量，许多研究都实施了血液透析内和透析外的运动干预措施。然而，在文献中仍然缺乏共识，即哪种运动干预措施更可行和有效。
本综述简要概述了以往研究中使用的血液透析内和透析外运动方案。我们还检查了与每种方法的可行性相关的数据，以及它们在改善心血管健康、肌肉质量、力量和身体功能方面的效果。
迄今为止发表的大多数血液透析内和中心外运动训练干预措施的益处都是适度的或不一致的。此外，就心血管健康、肌肉质量、力量和身体功能方面的益处而言，两者似乎都没有明显优于对方。一个值得关注的问题是，大多数血液透析内和中心外的运动干预措施都是强制性的运动处方，包括耐力或抗阻训练运动，强度较低，每周总共进行 60-135 分钟的运动。这种运动的量、强度和种类远低于大多数 PA 指南中推荐的量。这种类型的结构化活动对大多数患者来说也很枯燥。为了提高运动干预的效果，我们建议在血液透析期间，根据患者的个人需求和障碍，指导他们如何最好地将更多的活动融入日常生活中。
