Bogataj Špela, Pajek Maja, Kren Aljaž, Kurnik Mesarič Katja, Pajek Jernej
Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia.
Kidney Int Rep. 2024 Apr 15;9(7):2028-2036. doi: 10.1016/j.ekir.2024.04.029. eCollection 2024 Jul.
Hemodialysis (HD) patients frequently experience cognitive and physical impairments due to various factors, including age, comorbidities, and the demanding nature of the treatment. This study explores the impact of a 12 week integrated cognitive and physical training program on the functional capacity of patients on HD.
A single blind, randomized controlled trial was conducted with 44 patients on HD. Participants were divided into an experimental (EXP) group that received a combined intervention of intradialytic cycling and cognitive training, and a control (CON) group receiving standard HD treatment. The Trail Making Test (TMT), Timed Up and Go (TUG) test, and TUG dual task test (TUG-dual) were conducted before and after the intervention.
The EXP group demonstrated significant improvements in cognitive function, as evidenced by decreased TMT completion times (TMTA: -3.6 s, = 0.006; TMTB: -14.0 s, < 0.001; TMTB - TMTA: -10.4 s, = 0.004). In contrast, the CON group experienced a significant decline in TMTA and TMTB. In addition, the EXP group exhibited enhanced mobility, with reduced TUG completion times (-0.8 s, < 0.001) and improved cognitive motor performance in the TUG-dual (-1.0 s, < 0.001), whereas the CON group showed no significant changes.
This study demonstrates that a 12 week combined cognitive and physical training program during HD sessions significantly enhances cognitive function and mobility in patients on HD. These findings suggest that integrated interventions can mitigate functional declines in this population and improve their overall quality of life. Further research with larger samples and active control groups is warranted to confirm and expand upon these promising results.
由于年龄、合并症以及治疗要求严苛等多种因素,血液透析(HD)患者经常出现认知和身体功能障碍。本研究探讨了一项为期12周的综合认知与体能训练计划对HD患者功能能力的影响。
对44例HD患者进行了一项单盲随机对照试验。参与者被分为实验组(EXP),接受透析内骑行和认知训练的联合干预,以及对照组(CON),接受标准HD治疗。在干预前后进行了连线测验(TMT)、计时起立行走测试(TUG)和TUG双任务测试(TUG-dual)。
实验组在认知功能方面有显著改善,TMT完成时间缩短证明了这一点(TMTA:-3.6秒,P = 0.006;TMTB:-14.0秒,P < 0.001;TMTB - TMTA:-10.4秒,P = 0.004)。相比之下,对照组的TMTA和TMTB有显著下降。此外,实验组的活动能力增强,TUG完成时间缩短(-0.8秒,P < 0.001),TUG双任务中的认知运动表现改善(-1.0秒,P < 0.001),而对照组没有显著变化。
本研究表明,HD期间为期12周的认知与体能联合训练计划显著提高了HD患者的认知功能和活动能力。这些发现表明,综合干预可以减轻该人群的功能衰退,提高他们的整体生活质量。有必要进行更大样本和积极对照组的进一步研究,以证实并扩展这些有前景的结果。