[Physiotherapy during hemodialysis: results of a progressive resistance-training programme]

Abstract

During the last decades, aerobic exercise programs have shown beneficial effects on quality of life of End Stage Renal Disease (ESRD) patients, but there is still little evidence on the benefits of resistance training programmes. The aim of this study was to analyze the effects of a short strengthening exercise program for ESRD during hemodialysis on exercise and functional capacity and on quality of life.

Methods: 16 hemodialysis patients were assigned, according to their own election, to exercise (N>or=8) or control group (N>or=8). The experimental group performed a 6-month duration intradialytic exercise program supervised by a physiotherapist, consisting of a battery of isometric and isotonic exercises for the lower limbs. Control group remained sedentary. A graded exercise test (Naughton protocol), functional measurements (<<6 minutes walking test>> 6MWT and 'sit to stand to sit tests' STS-10 and STS-60), and the SF-36, to assess quality of life were measured pre and post intervention in the experimental group, while the control group only completed the SF-36 questionnaire.

Results: Considering the experimental group, both time and METS increased after the intervention, although it was not significant. Meters measured in the 6MWT significantly increased after the intervention (399.57+/-39.56 meters pre-intervention; 471.71+/-70.63 meters post-intervention p<0.01). Both time on the STS-10 (22.52+/-4.77 seconds pre-intervention; 17.71+/-1.79 seconds post-intervention p<0.05) and repetitions on the STS-60 (28.57+/-5.12 repetitions pre-intervention; 31.42+/-2.443 repetitions post-intervention p<0.05) significantly improved after the intervention. After training, the mental component scale of the SF-36 significantly increased in the experimental group compared to baseline (41.74+/-9.25 before; 50.61+/-12.13 after, p<0.05), while the control group showed a significant decrease (48.19 +/- 16.1 before; 33.7+/- 13.8 after, p<0.05). Comparison between groups also showed a significant difference in the mental component scale after the intervention (p<0.05).

Conclusion: It is concluded that a strengthening exercise program during hemodialysis improves the functional capacity of ESRD patients (walking and standing from a seat) and improves the mental component of quality of life perceived by dialysis patients.