Training with an Electric Exercise Bike versus a Conventional Exercise Bike during Hemodialysis for Patients with End-stage Renal Disease: A Randomized Clinical Trial

Abstract

Objective: Hemodialysis (HD) patients have lower fitness levels than healthy subjects because of various structural, metabolic, and functional abnormalities secondary to uremic changes in skeletal muscles. Aerobic and resistance exercises are beneficial in improving not only physical function, including maximal oxygen uptake and muscle strength, but also anthropometrics, nutritional status, and hematologic indices. The use of electric ergometers that place light loads on patients has been implemented at many dialysis facilities in Japan. However, reports comparing the effects on body function of electric and variable-load ergometers are few. This study aimed to compare electric ergometers and variable-load ergometers in terms of exercise outcomes in HD patients.

Methods: A total of 15 ambulatory HD patients were randomly divided into two groups: the variable-load ergometer group (n=8) and the electric ergometer group (n=7). HD patients exercised at a level based on their physical function three times a week for 12 weeks.

Results: After the 12-week intervention period, only the variable-load ergometer group experienced significant increases in lower extremity muscle strength and exercise tolerance.

Conclusion: This study confirmed that conventional aerobic training and electric bike exercise during HD were efficacious and safe without causing sudden hypotension or any other side effects. However, exercise using a variable-load ergometer may be more effective than exercise using an electric bike in improving the physical function of HD patients. Exercise using a variable-load ergometer elicited specific whole-body and local effects.

Keywords: aerobic exercise; electric bike training; hemodialysis.

Fig. 1.

Variable-load ergometer exercise equipment (TE2-70; Showa Denki Co., Ltd., Osaka, Japan). The subjects set the time and variable load to Borg 11–13 RPE. They performed up to 1 h of exercise during the first half of hemodialysis three times a week for 12 continuous weeks. The exercise duration and loads were set according to the physical function of each patient. During exercise, the subjects maintained their heart rate within 40 beats/min above their resting heart rate.

Fig. 2.

Electric ergometer exercise equipment (PBE-100; Meisei Co., Ltd., Osaka, Japan). The subjects set the time and speed that allowed them to maintain Borg 11–13 RPE. They performed up to 1 h of exercise during the first half of hemodialysis three times a week for 12 continuous weeks. The exercise duration was based on the physical function of each patient. During exercise, the subjects maintained their heart rate within 40 beats/min above their resting heart rate.