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Review
. 2024 Apr 20:42:102737.
doi: 10.1016/j.pmedr.2024.102737. eCollection 2024 Jun.

Quantifying the dose-response relationship between exercise and health-related quality of life in patients undergoing haemodialysis: A meta-analysis

Wanli Zang  1 , Mingqing Fang  2 , Ningkun Xiao  3 , Xianzuo Zhang  4 , Changchun Lin  2 , Su Wang  5
Affiliations
Review

Quantifying the dose-response relationship between exercise and health-related quality of life in patients undergoing haemodialysis: A meta-analysis

Wanli Zang et al. Prev Med Rep. .

Abstract

Objective: This meta-analysis aims to explore the dose-response relationship of aerobic exercise or aerobic combined resistance exercise on cardiopulmonary function in maintenance hemodialysis（MHD）, with the goal of aiding in the formulation of precise exercise prescriptions.

Methods: A literature search up to August 18, 2023, was conducted in databases including Web of Science, among others, focusing on the effects of exercise interventions on cardiopulmonary function in hemodialysis patients.Two researchers independently conducted literature screening, data extraction, and an assessment of study methodology quality. A dose-response meta-analysis was carried out using a one-stage cubic spline mixed-effects model, followed by stratified analyses based on intervention period, intervention method, and exercise environment.

Results: A nonlinear dose-response relationship was observed between exercise and 6-minute walk test (6WMT) as well as peak oxygen uptake (VO2Peak) in hemodialysis patients. The optimal exercise dose for the 6WMT across the full exposure range was 922 METs-min/week, with VO2Peak increasing with the dose. The effects were influenced by the type of exercise, intervention period, and exercise environment. An exercise dose of 500 METs-min/week and 619 METs-min/week was found sufficient to achieve the minimal clinically important differences (MCID) for 6WMT and VO2Peak, respectively.

Conclusion: There is a significant association between the dose of exercise and its effects. With appropriate adjustment of variables, even low-dose exercise can lead to clinically significant improvements in cardiopulmonary function.

Keywords: 6 min walking ability; Cardiopulmonary function; Exercise; Hemodialysis; Meta-analysis of dose response; Peak oxygen uptake.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Flowchart of Literature Screening for Meta-Analysis on Exercise and Health Outcomes in Hemodialysis Patients.
Fig. 2
Fig. 2
Dose-Response Relationship of Exercise on 6-Minute Walking Capacity (A) and Peak Oxygen Uptake (B) in Hemodialysis Patients.
Fig. 3
Fig. 3
Subgroup Analysis of Dose-Response Relationship between Exercise Intensity and 6-Minute Walking Ability and Peak Oxygen Uptake in Hemodialysis Patients.
See this image and copyright information in PMC

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