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透析期间运动对住院血液透析患者日常生活活动能力和身体功能的影响:一项疗效与安全性研究

The Impact of Intradialytic Exercise on Activities of Daily Living and Physical Function in Hospitalized Hemodialysis Patients: A Study of Efficacy and Safety.

作者信息

Takahashi Ren, Yabe Hiroki, Ishikawa Hideaki, Hibino Takashi, Suzumura Akio, Yamada Tetsuya

机构信息

Department of Rehabilitation, Kaikoukai Josai Hospital, Nagoya, Japan.

Department of Physical Therapy, Seirei Christopher University, School of Rehabilitation, Hamamatsu, Japan.

出版信息

JMA J. 2025 Jul 15;8(3):834-845. doi: 10.31662/jmaj.2024-0349. Epub 2025 Jun 6.

Abstract

INTRODUCTION

This study aimed to examine the effects of intradialytic exercise (IDE) on improving activities of daily living (ADL) and physical function in hospitalized hemodialysis (HD) patients. The research question focused on improving outcomes in ADL and physical function.

METHODS

This study is a single-center, historical cohort study. Subjects were hospitalized HD patients undergoing rehabilitation between April 2017 and February 2023. Patients were divided into two groups: the IDE group, which received IDE, and the non-IDE group, which did not. The outcomes measured were Barthel Index (BI), grip strength, isometric knee extension strength (IKES), 10-meter walking speed (10MWS), and Short Physical Performance Battery (SPPB). Outcome measures were taken at admission and discharge, and changes were analyzed using a linear mixed model.

RESULTS

The study included 76 participants (IDE group: 13, non-IDE group: 63). The IDE group showed significant improvements in ΔBI (13.7 [0.96-26.38] points) and Δ10MWS (0.25 [0.05-0.45] m/sec) (p < 0.05). No significant differences were observed between the two groups in ΔGrip strength (2.10 [-0.40 to 4.60] kg), ΔIKES (7.40 [-2.20 to 17.02] %), or ΔSPPB (1.23 [-0.48 to 2.94] points) (p > 0.05). However, the IDE group showed significant pre-post improvements in grip strength (1.55 [1.46-1.65] kg) and SPPB (2.44 [1.34-3.55] points) (p < 0.05).

CONCLUSIONS

IDE contributed to greater improvements in BI and 10MWS in HD patients. These findings suggest that adding IDE to inpatient rehabilitation may enhance functional recovery in this population.

摘要

引言

本研究旨在探讨透析期间运动(IDE)对改善住院血液透析(HD)患者日常生活活动能力(ADL)和身体功能的影响。研究问题聚焦于改善ADL和身体功能的结果。

方法

本研究是一项单中心历史队列研究。研究对象为2017年4月至2023年2月期间正在接受康复治疗的住院HD患者。患者分为两组:接受IDE的IDE组和未接受IDE的非IDE组。测量的结果指标包括巴氏指数(BI)、握力、等长膝关节伸展力量(IKES)、10米步行速度(10MWS)和简短体能状况量表(SPPB)。在入院时和出院时进行结果测量,并使用线性混合模型分析变化情况。

结果

该研究纳入了76名参与者(IDE组:13名,非IDE组:63名)。IDE组在ΔBI(13.7 [0.96 - 26.38]分)和Δ10MWS(0.25 [0.05 - 0.45]米/秒)方面有显著改善(p < 0.05)。两组在Δ握力(2.10 [-0.40至4.60]千克)、ΔIKES(7.40 [-2.20至17.02]%)或ΔSPPB(1.23 [-0.48至2.94]分)方面未观察到显著差异(p > 0.05)。然而,IDE组在握力(1.55 [1.46 - 1.65]千克)和SPPB(2.44 [1.34 - 3.55]分)方面有显著的前后改善(p < 0.05)。

结论

IDE有助于HD患者在BI和10MWS方面有更大改善。这些发现表明,在住院康复中增加IDE可能会增强该人群的功能恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0889/12328902/1c389ff1796c/2433-3298-8-3-0834-g001.jpg

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