Department of Health Psychology and Research Methodology, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.
Graduate School Kosice Institute for Society and Health, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia.
Disabil Rehabil. 2022 Jan;44(2):275-281. doi: 10.1080/09638288.2020.1766581. Epub 2020 May 24.
The loss of muscle functions is a significant health issue among dialysis patients. Poor muscle strength negatively affects a patient's mobility, independence and quality of life. The aim of the study was to assess the effects of an intradialytic resistance training (IRT) on lower extremity muscle functions among dialysed patients.
Ninety patients were allocated into an experimental group ( = 57) or control group (CNG) ( = 33) according to the location of the dialysis service center. Fifty-eight patients completed the study follow-up. The intervention regarded 12-week IRT, while the controls remained physically inactive during hemodialysis. In both groups of patients, we assessed lower extremity muscle functions by a diagnostics of maximal isometric force generated during hip flexion (HF), hip extension (HE), and knee extension (KE) contractions at baseline, after the 12-weeks intervention and after a further 12-weeks follow up.
We found that improvements in HE between baseline and post-intervention were significantly larger for the experimental than the CNG (difference 32.0, 95% CI = 12.3-51.8, = 0.002). For the other primary outcomes, we found no differences between the groups, and neither for the two other indices of muscle strength (HF and KE). At 12-weeks follow-up, we found no statistically significant differences between the two groups.
Our findings indicate that exercise during dialysis not just suppresses adverse effects in muscle strength and functioning, but effectively and safely increases lower extremities muscle function in a relatively short time.Implications for RehabilitationRegular, progressive, resistance training realized during dialysis is well tolerated and safe for exercise interventions in hemodialysis patients.A 12-weeks intradialytic resistance training is effective in the prevention and clinical management of muscle function loss among hemodialysis patients.The range of improvements in muscle functions, demonstrated by the assessment of maximal isometric force, varied severely during different lower extremity movements of hemodialysis patients.
肌肉功能丧失是透析患者的一个重大健康问题。肌肉力量不足会严重影响患者的活动能力、独立性和生活质量。本研究旨在评估透析患者的透析内抗阻训练（IRT）对下肢肌肉功能的影响。
根据透析服务中心的位置，将 90 名患者分为实验组（n=57）或对照组（n=33）。58 名患者完成了研究随访。干预措施为 12 周的 IRT，而对照组在血液透析期间保持不活动。在两组患者中，我们通过髋关节屈曲（HF）、髋关节伸展（HE）和膝关节伸展（KE）收缩时产生的最大等长力的诊断评估下肢肌肉功能，在基线、12 周干预后和进一步的 12 周随访时进行评估。
我们发现，与对照组相比，实验组的 HE 在基线和干预后的改善明显更大（差异为 32.0，95%CI=12.3-51.8， = 0.002）。对于其他主要结果，我们没有发现两组之间存在差异，也没有发现其他两个肌肉力量指标（HF 和 KE）存在差异。在 12 周的随访中，我们没有发现两组之间存在统计学上的显著差异。
我们的研究结果表明，透析期间的运动不仅可以抑制肌肉力量和功能的不良影响，而且可以在相对较短的时间内有效和安全地增加下肢肌肉功能。
在血液透析患者中，规律的、渐进的、在透析期间进行的抗阻训练是可以耐受的，也是安全的运动干预措施。12 周的透析内抗阻训练对预防和临床管理血液透析患者的肌肉功能丧失是有效的。通过评估最大等长力，血液透析患者在不同的下肢运动中肌肉功能的改善幅度差异很大。
