Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Mikatahara, Kita-ku, Hamamatsu, Shizuoka, Japan.
Department of Physical Therapy, International University of Health and Welfare, School of Health Sciences at Narita, Kozunomori, Narita, Chiba, Japan.
PLoS One. 2021 Oct 22;16(10):e0257918. doi: 10.1371/journal.pone.0257918. eCollection 2021.
Previous reports have shown the benefits of intradialytic exercise to patients undergoing hemodialysis. However, most of those studies assessed the effects of exercise in middle-aged patients and little is known about advanced-age patients undergoing hemodialysis. Therefore, the present randomized controlled trial was performed to determine the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. This non-blinded, randomized controlled parallel trial enrolled a total of 101 patients who were randomly assigned to intradialytic exercise (n = 51) or usual care (n = 50) groups. The training program included both resistance and aerobic exercises and was performed three times per week for 6 months. The aerobic exercise intensity was adjusted to a target Borg score of 13 for 20 minutes. Four types of resistance exercises were performed using elastic tubing, with three sets of 10 exercises performed at moderate intensity (13/20 on the Borg scale). The usual care group received standard care. Lower extremity muscle strength, Short Physical Performance Battery score, and 10-m walking speed were the outcomes and were evaluated before the hemodialysis session and after 6 months of training. There were statistically significant improvements in Short Physical Performance Battery score (effect size, 0.57; 95% confidence interval, 0.15‒1.95) in the exercise group relative to the control group. There were no statistically significant differences in lower extremity muscle strength or in the 10-m walking speed between the two groups. These findings suggest that 6 months of intradialytic training could improve physical function in older patients undergoing hemodialysis.
先前的报告表明，血液透析患者进行透析内运动有诸多益处。然而，这些研究大多评估了中年患者运动的效果，而对于接受血液透析的老年患者则知之甚少。因此，本随机对照试验旨在确定运动疗法对接受血液透析的老年患者的有效性。这项非盲、随机对照平行试验共纳入 101 名患者，他们被随机分配到透析内运动（n = 51）或常规护理（n = 50）组。训练方案包括阻力运动和有氧运动，每周进行 3 次，持续 6 个月。有氧运动强度调整为目标 Borg 评分 13，持续 20 分钟。使用弹性管进行 4 种阻力运动，中等强度（Borg 量表上的 13/20）进行 3 组 10 次运动。常规护理组接受标准护理。下肢肌肉力量、短体力量测试评分和 10 米步行速度是试验结果，在透析前和 6 个月训练后进行评估。与对照组相比，运动组的短体力量测试评分有显著提高（效应量，0.57；95%置信区间，0.15-1.95）。两组之间下肢肌肉力量或 10 米步行速度无统计学差异。这些发现表明，6 个月的透析内训练可以改善接受血液透析的老年患者的身体功能。
