Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients

Ji-Hyung Cho; Ji-Yeon Lee; Sukyung Lee; Hyuntae Park; Seung-Wook Choi; Jun Chul Kim

doi:10.1007/s11255-018-1796-y

Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients

Int Urol Nephrol. 2018 Apr;50(4):745-754. doi: 10.1007/s11255-018-1796-y. Epub 2018 Jan 23.

Authors

Ji-Hyung Cho¹, Ji-Yeon Lee², Sukyung Lee³, Hyuntae Park⁴, Seung-Wook Choi⁵, Jun Chul Kim⁶

Affiliations

¹ Division of Nephrology and Department of Internal Medicine, CHA Gumi Medical Center, CHA University, 12 Sinsi-ro 10-gil, Gumi-si, Gyeongsangbuk-do, 39295, South Korea.
² Department of Physical Education, Sungshin Women's University, Seoul, South Korea.
³ Department of Internal Medicine, Semyung Christianity Hospital, Pohang-si, Gyeongsangbuk-do, South Korea.
⁴ Department of Health Care and Science, Dong-A University, Busan, South Korea.
⁵ Department of Sports and Leisure, Sungshin Women's University, Seoul, South Korea.
⁶ Division of Nephrology and Department of Internal Medicine, CHA Gumi Medical Center, CHA University, 12 Sinsi-ro 10-gil, Gumi-si, Gyeongsangbuk-do, 39295, South Korea. truedoc1@hanmail.net.

PMID: 29362960
DOI: 10.1007/s11255-018-1796-y

Abstract

Purpose: Physical inactivity and sleep disturbance are frequently observed and relate to poor clinical outcomes in maintenance hemodialysis patients. We aimed to investigate the effect of intradialytic exercise on daily physical activity and sleep quality, measured by an accelerometer, in maintenance hemodialysis patients.

Methods: This study randomly assigned ambulatory maintenance hemodialysis patients aged ≥ 20 years on dialysis ≥ 6 months, without a hospitalization history for the previous 3 months to 4 groups: aerobic exercise (AE), resistance exercise (RE), combination exercise (CE), and control. A stationary bike was used for AE and a TheraBand^®/theraball for RE. A 12-week intradialytic exercise program (3 times/week) was completed in the AE (n = 11), RE (n = 10), and CE (n = 12) groups. The control group (n = 13) received only warm-up stretching. At baseline and 12-week follow-up, daily physical activity and sleep quality were measured with a triaxial accelerometer (wActiSleep-BT; ActiGraph, Pensacola, FL) during a continuous 7-day wear period.

Results: We observed a significant increase in metabolic equivalent (MET; kcal/h/kg) in the AE (1.02 ± 0.03 vs 1.04 ± 0.04, P = 0.04) and CE (1.06 ± 0.05 vs 1.09 ± 0.08, P = 0.01) groups at 12 weeks compared with baseline. When comparing between-group changes in MET, there was a significant increase in METs in the CE group (0.03 ± 0.03 vs - 0.01 ± 0.04, P = 0.02) compared with the control group. The total number of sedentary bouts (per week) decreased significantly in the AE (200 ± 37 vs 174 ± 36, P = 0.01), RE (180 ± 31 vs 130 ± 49, P = 0.03), and CE groups (180 ± 45 vs 152 ± 46, P = 0.04) at 12 weeks compared with baseline. The average sleep fragmentation index, indicating poor sleep quality, decreased significantly at 12 weeks compared with baseline in the AE (51.4 ± 8.0 vs 44.5 ± 9.6, P = 0.03) and RE groups (52.3 ± 7.3 vs 40.0 ± 15.4, P = 0.01).

Conclusions: Intradialytic exercise appears to be clinically beneficial in improving daily physical activity and sleep quality in maintenance hemodialysis patients.

Keywords: Accelerometry; End-stage renal disease; Exercise; Hemodialysis; Sleep.

Publication types

Randomized Controlled Trial

MeSH terms

Accelerometry
Adult
Aged
Exercise / physiology*
Female
Humans
Kidney Failure, Chronic / physiopathology
Kidney Failure, Chronic / therapy*
Male
Metabolic Equivalent
Middle Aged
Renal Dialysis*
Resistance Training*
Sleep*