Noguchi Masahiro, Yamaguchi Shinichi, Tanaka Miho, Koshino Yoshitaka
Course of Rehabilitation, Kinjo University Graduate School of Rehabilitation, Japan.
Department of Physical Therapy, Koshino Internal Medical Clinic, Japan.
Phys Ther Res. 2021 Dec 6;25(1):12-17. doi: 10.1298/ptr.E10144. eCollection 2022.
It is important for hemodialysis patients to exercise while their nutritional status is being monitored. This study aimed to examine the difference in physical exercise function and the effect of exercise intervention in hemodialysis patients who were divided into two groups (high-nutrition and low-nutrition groups) based on the serum albumin levels.
A total of 26 outpatients (18 men and 8 women) undergoing hemodialysis (age: 66 ± 10 years) were included in this study. The patients' body composition data (weight, body mass index, percentage of body fat, fat-free mass, and total body water) and physical functions (grip strength, knee extensor strength, open-eyed one-legged standing time, long sitting trunk anteflexion, and 6-minute walking distance [6MWD] test) were measured. The intervention was supine ergometer exercise during hemodialysis, and the patients exercised for 30 minutes during hemodialysis thrice a week. The intervention period was three months.
Compared to the high-nutrition group, the low-nutrition group showed a significant decrease in muscle strength. Furthermore, long sitting trunk anteflexion in the high-nutrition group and 6MWD in the low-nutrition group improved significantly after the intervention.
The result of this study may indicate that 6MD can be improved by exercise during dialysis, regardless of nutritional status. It is said that low nutritional status has a negative impact on survival rate; thus, considering the impact on survival rate, it is hemodialysis patients with a low nutritional status that should be considered to introduce more active exercise during dialysis.
在监测血液透析患者营养状况的同时让其进行锻炼很重要。本研究旨在探讨根据血清白蛋白水平分为两组（高营养组和低营养组）的血液透析患者在体育锻炼功能方面的差异以及运动干预的效果。
本研究纳入了26名接受血液透析的门诊患者（18名男性和8名女性）（年龄：66±10岁）。测量了患者的身体成分数据（体重、体重指数、体脂百分比、去脂体重和总体水）和身体功能（握力、膝关节伸肌力量、睁眼单腿站立时间、长坐躯干前屈和6分钟步行距离[6MWD]测试）。干预措施是在血液透析期间进行仰卧位测力计运动，患者在血液透析期间每周进行三次，每次30分钟。干预期为三个月。
与高营养组相比，低营养组的肌肉力量显著下降。此外，干预后高营养组的长坐躯干前屈和低营养组的6MWD均有显著改善。
本研究结果可能表明，无论营养状况如何，透析期间的运动均可改善6MWD。据说营养状况不佳会对生存率产生负面影响；因此，考虑到对生存率的影响，应考虑让营养状况不佳的血液透析患者在透析期间进行更积极的运动。
