Hu Huagang, Jiang Xiaomei, Huang Ying, Zeng Ying, Xu Qinjuan, Wu Chanchan, Chau Pui Hing, Choi Edmond Pui Hang
School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.
School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Clin J Am Soc Nephrol. 2025 Apr 4;20(6):844-853. doi: 10.2215/CJN.0000000701.
We compared the effectiveness of walking training with and without blood flow restriction on walking capacity in hemodialysis patients. Blood flow restriction walking resulted in greater improvements in walking capacity than usual care in hemodialysis patients. The low-intensity, simple walking-based intervention may be an effective complementary intervention for patients treated with hemodialysis.
The decline in walking capacity among patients undergoing maintenance hemodialysis can worsen physical function, leading to impaired health-related quality of life (HRQOL). This randomized controlled trial compared the effectiveness of walking training with blood flow restriction (WT-BFR) and walking training (WT) versus usual care controls on walking capacity among hemodialysis patients.
Patients treated with maintenance hemodialysis were recruited from two dialysis units in Suzhou, China, between February and June 2024 and were randomly allocated into three groups using block randomization. The control group (CG) received usual care. The WT group received 8 weeks of low-to-moderate intensity walking intervention. The WT-BFR group received the same intervention as the WT group, with the addition of 40%–50% limb occlusion pressure applied during walking sessions. Walking capacity (primary outcome), physical function, HRQOL, anxiety, and depression were assessed at baseline, 8, and 16 weeks.
Fifty-seven eligible patients with a mean age of 54 years (SD=10) were recruited. They were randomly allocated equally into the CG (=19), WT-BFR group (=19), and WT group (=19). From baseline to 8 weeks, the improvements in walking capacity were greater in the WT-BFR (mean differences and 95% confidence interval, 48.48, 28.81 to 68.16 m) and WT (31.70, 9.29 to 54.11 m) groups compared with the CG. At 16 weeks, the WT-BFR group also demonstrated a greater improvement in walking capacity than the WT group (34.63, 8.90 to 60.36 m). Similarly, the WT-BFR and WT groups showed greater improvements in physical function and disease-specific domains of HRQOL, compared with the CG.
After an 8-week intervention, both WT-BFR and WT improved walking capacity, physical function, and HRQOL in maintenance hemodialysis patients. However, the prolonged benefits of WT-BFR in the hemodialysis population require further investigation.
: Chinese Clinical Trial Register registration number: ChiCTR2400080779.
我们比较了有血流限制和无血流限制的步行训练对血液透析患者步行能力的有效性。与血液透析患者的常规护理相比，血流限制步行能使步行能力得到更大改善。这种低强度、基于简单步行的干预可能是血液透析患者有效的辅助干预措施。
维持性血液透析患者步行能力下降会使身体功能恶化，导致健康相关生活质量（HRQOL）受损。这项随机对照试验比较了有血流限制的步行训练（WT-BFR）和步行训练（WT）与常规护理对照对血液透析患者步行能力的有效性。
2024年2月至6月期间，从中国苏州的两个透析单位招募接受维持性血液透析的患者，并采用区组随机化将其随机分为三组。对照组（CG）接受常规护理。WT组接受为期8周的低至中等强度步行干预。WT-BFR组接受与WT组相同的干预，在步行训练期间增加40% - 50%的肢体闭塞压力。在基线、第8周和第16周评估步行能力（主要结局）、身体功能、HRQOL、焦虑和抑郁情况。
招募了57名符合条件的患者，平均年龄54岁（标准差 = 10）。他们被平均随机分配到CG组（= 19）、WT-BFR组（= 19）和WT组（= 19）。从基线到第8周，与CG组相比，WT-BFR组（平均差异和95%置信区间，48.48，28.81至68.16米）和WT组（31.70，9.29至54.11米）的步行能力改善更大。在第16周，WT-BFR组的步行能力改善也比WT组更大（34.63，8.90至60.36米）。同样，与CG组相比，WT-BFR组和WT组在身体功能和HRQOL的疾病特异性领域也有更大改善。
经过8周干预，WT-BFR和WT均改善了维持性血液透析患者的步行能力、身体功能和HRQOL。然而，WT-BFR在血液透析人群中的长期益处需要进一步研究。
中国临床试验注册中心注册号：ChiCTR240008
