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基于视频的锻炼计划对腹膜透析患者营养状况和生活质量的有效性:一项前瞻性随机对照试验。

Effectiveness of a video-based exercise program on nutritional status and quality of life of peritoneal dialysis patients: A pilot randomized controlled trial.

作者信息

Luo Yixin, Yang Zhen, Li Haoyu, Chen Xiuyu, Huang Yanlin

出版信息

Clin Nephrol. 2023 Mar;99(3):105-117. doi: 10.5414/CN110868.

Abstract

OBJECTIVE

To evaluate the effectiveness of a video-based exercise program on nutritional status and quality of life (QOL) of peritoneal dialysis (PD) patients.

MATERIALS AND METHODS

Participants satisfying the inclusion and exclusion criteria were recruited and divided into the intervention group and the control group. The intervention group received video-based exercise based on a manual advocated by the National Kidney Foundation, while the control group received routine exercise guidance. Their nutritional indicators and the Quality of Life Scale for Peritoneal Dialysis patients (QLSPD) scores were collected and analyzed.

RESULTS

No adverse events occurred during the study. Baseline data between the two groups were comparable, and there were no significant differences in body mass index (BMI) (t = 0.214, p = 0.831), triceps skin fold thickness (TSF) (t = 0.407, p = 0.685), arm muscle circumference (AMC) (t = 0.310, p = 0.757), grip strength (Gs) (t = 0.557, p = 0.579), calf circumference (Cc) (t = 0.441, p = 0.660), serum albumin (Alb) (t = 0.261, p = 0.795), prealbumin (PA) (t = 0.218, p = 0.828), hemoglobin (Hb) (t = 0.114, p = 0.909), triglyceride (TG) (t = 0.192, p = 0.848), total cholesterol (TC) (t = 0.092, p = 0.927), low-density lipoprotein (LDL) (t = 0.124, p = 0.902), high-density lipoprotein (HDL) (t = 0.265, p = 0.792), blood urea nitrogen (BUN) (t = 0.540, p = 0.590), serum creatinine (SCr) (t = 0.255, p = 0.799), total urea clearance index (Kt/V) (t = 0.958, p = 0.340), total creatinine clearance rate (Ccr) (t = 0.166, p = 0.868), protein equivalent of nitrogen appearance (nPNA) (t = 0.240, p = 0.811), and QLSPD scores (p > 0.05) between the two groups at the baseline measures. However, after 12 weeks of intervention, the AMC (t = 2.993, p = 0.003) and Cc (t = 2.811, p = 0.006) of the intervention group improved significantly compared with the control group. The BMI (t = 2.068, p = 0.041) and TSF (t = 2.578, p = 0.011) showed a trend of improvement compared with baseline. And the intervention group scored less in body physiology function (t = 7.084, p < 0.001), disease factors (t = 13.336, p < 0.001), mental state (t = 9.555, p < 0.001), and social role (t = 5.156, p < 0.001) components, while their satisfaction hardly changed (t = 0.240, p = 0.811).

CONCLUSION

The video-based exercise intervention is safe and can remarkably improve the nutritional status and QOL of PD patients.

摘要

目的

评估基于视频的运动方案对腹膜透析(PD)患者营养状况及生活质量(QOL)的有效性。

材料与方法

招募符合纳入及排除标准的参与者,并将其分为干预组和对照组。干预组接受基于美国国家肾脏基金会手册的视频运动,而对照组接受常规运动指导。收集并分析他们的营养指标及腹膜透析患者生活质量量表(QLSPD)得分。

结果

研究期间未发生不良事件。两组间基线数据具有可比性,在基线测量时,两组在体重指数(BMI)(t = 0.214,p = 0.831)、肱三头肌皮褶厚度(TSF)(t = 0.407,p = 0.685)、上臂肌肉周长(AMC)(t = 0.310,p = 0.757)、握力(Gs)(t = 0.557,p = 0.579)、小腿周长(Cc)(t = 0.441,p = 0.660)、血清白蛋白(Alb)(t = 0.261,p = 0.795)、前白蛋白(PA)(t = 0.218,p = 0.828)、血红蛋白(Hb)(t = 0.114,p = 0.909)、甘油三酯(TG)(t = 0.192,p = 0.848)、总胆固醇(TC)(t = 0.092,p = 0.927)、低密度脂蛋白(LDL)(t = 0.124,p = 0.902)、高密度脂蛋白(HDL)(t = 0.265,p = 0.792)、血尿素氮(BUN)(t = 0.540,p = 0.590)、血清肌酐(SCr)(t = 0.255,p = 0.799)、总尿素清除指数(Kt/V)(t = 0.958,p = 0.340)、总肌酐清除率(Ccr)(t = 0.166,p = 0.868)、蛋白质氮呈现量(nPNA)(t = 0.240,p = 0.811)及QLSPD得分(p > 0.05)方面均无显著差异。然而,经过12周干预后,干预组的AMC(t = 2.993,p = 0.003)和Cc(t = 2.811,p = 0.006)与对照组相比有显著改善。BMI(t = 2.068, p = 0.041)和TSF(t = 2.578, p = 0.011)与基线相比呈现改善趋势。并且干预组在身体生理功能(t = 7.084,p < 0.001)、疾病因素(t = 13.336,p < 0.001)、精神状态(t = 9.555,p < 0.001)和社会角色(t = 5.156,p < 0.00)分量表得分更低,而他们的满意度几乎没有变化(t = 0.240,p = 0.811)。

结论

基于视频的运动干预是安全的,并且可以显著改善PD患者的营养状况及生活质量。

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