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群组集抗阻训练对老年血液透析患者力量、功能能力、代谢及炎症状态的影响:一项随机对照临床试验

Impact of cluster set resistance training on strength, functional capacity, metabolic and inflammatory state in older hemodialysis subjects: A randomized controlled clinical trial.

作者信息

Magalhães de Castro Bruno, Dos Santos Rosa Thiago, de Araújo Thaís Branquinho, de Luca Corrêa Hugo, de Deus Lysleine Alves, Neves Rodrigo Vanerson Passos, Reis Andrea Lucena, Dos Santos Rafael Lavarini, da Silva Barbosa Jéssica Mycaelle, de Sousa Honorato Fernando, da Motta Vilalva Mestrinho Vitória Marra, Tzanno-Martins Carmen, Navalta James W, Prestes Jonato

机构信息

Department of Physical Education, Catholic University of Brasilia, Brasilia, DF, Brazil.

Department of Physical Education, Catholic University of Brasilia, Brasilia, DF, Brazil; Graduate Program in Genomic Science and Biotechnology.

出版信息

Exp Gerontol. 2023 Oct 15;182:112297. doi: 10.1016/j.exger.2023.112297. Epub 2023 Oct 4.

Abstract

BACKGROUND AND AIMS

Hemodialysis-associated neuromuscular dysfunction appears to be counteracted by resistance training (RT) in older patients with chronic kidney disease (CKD). Thus, the aim of the present study was to evaluate the impact of cluster-set RT protocol on anthropometric parameters, functional capacities, and biochemical variables in older patients with CKD.

METHODS AND RESULTS

Seventy-eight older patients (age: 57.55 ± 4.06 years) with CKD undergoing maintenance hemodialysis participated, and were randomly divided into control group (CG, N = 26), traditional RT (RT, N = 26) and cluster-set RT (RT-CS, N = 26) groups. Participants completed 24 weeks of RT three times per week, 1 h and 30 min before the hemodialysis session. Patients from the RT-CS group displayed increased adherence as compared to the RT group (66.35 % versus 61.73 %, p < 0.0001). There was an improvement of all anthropometric variables, handgrip strength, timed up and-go (TUG) and six-minute walking test (6MWT) following both training protocols when compared to control group and pre-intervention values. Fasting blood glucose decreased for both RT and RT-CS groups as compared with pre-intervention, without differences between training protocols and CG. Glycated hemoglobin, inflammatory cytokines, and triglycerides decreased in RT and RT-CS groups as compared with pre-intervention and CG, without differences between them. Furthermore, the RT-CS protocol resulted in a greater number of people who were responsive to training when compared to traditional training.

CONCLUSIONS

RT-CS is a clinically valuable tool to improve anthropometric parameters, handgrip strength, TUG, 6MWT, fasting blood glucose, and cytokines in CKD older patients.

摘要

背景与目的

在老年慢性肾脏病(CKD)患者中,阻力训练(RT)似乎可对抗血液透析相关的神经肌肉功能障碍。因此,本研究旨在评估分组训练RT方案对老年CKD患者人体测量参数、功能能力和生化变量的影响。

方法与结果

78例接受维持性血液透析的老年CKD患者(年龄:57.55±4.06岁)参与研究,随机分为对照组(CG,N = 26)、传统RT组(RT,N = 26)和分组训练RT组(RT-CS,N = 26)。参与者每周进行3次RT,共24周,在血液透析前1小时30分钟进行。与RT组相比,RT-CS组患者的依从性更高(66.35%对61.73%,p < 0.0001)。与对照组和干预前值相比,两种训练方案后所有人体测量变量、握力、计时起立行走测试(TUG)和6分钟步行测试(6MWT)均有改善。与干预前相比,RT组和RT-CS组的空腹血糖均降低,训练方案与CG组之间无差异。与干预前和CG组相比,RT组和RT-CS组的糖化血红蛋白、炎性细胞因子和甘油三酯均降低,两组之间无差异。此外,与传统训练相比,RT-CS方案使更多患者对训练有反应。

结论

RT-CS是改善老年CKD患者人体测量参数、握力、TUG、6MWT、空腹血糖和细胞因子的一种具有临床价值的工具。

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