Seven months of aerobic intradialytic exercise training can prevent muscle loss in haemodialysis patients: an ultrasonography study

Int Urol Nephrol. 2022 Feb;54(2):447-456. doi: 10.1007/s11255-021-02931-6. Epub 2021 Jun 28.

Abstract

Purpose: This study aimed to evaluate the effects of 7-month intradialytic exercise training (IDE) on vastus lateralis (VL) muscle architecture, functional capacity and quality of life in stable haemodialysis (HD) patients.

Methods: 44 HD patients were randomly assigned into an Exercise Group (EG = 21), which they received 7 months of IET, at 60% of pre-assessed maximum aerobic power, 3/week) or into a Control Group (CG = 23, no exercise). VL architecture was evaluated with ultrasonography, functional capacity was assessed using a series of functional tests (6 min walking test, 5 repetitions sit-to-stand, sit-to-stand 60 s, handgrip strength), and maximal aerobic power determined with a modified version of the Åstrand test. Quality of life and fatigue levels were evaluated using validated questionnaires.

Results: VL fascicle angle and length did not change significantly in both groups (P > 0.05). Muscle thickness decreased in CG (P = 0.02) while it was fully preserved in the EG. Functional capacity increased only in the EG (6 min walking test 15.79 ± 12.35%, P < 0.001; max aerobic power 26.36 ± 1.24%, P < 0.001; STS-60rep: 10.23 ± 1.60%, P < 0.000; hand grip strength: 5.14 ± 28.30%, P < 0.02).

Conclusion: Intradialytic aerobic exercise training, improves functional capacity and prevents thigh muscle mass loss in HD patients. It is evident that muscle ultrasonography could play a pivotal role in assessing muscle quality changes in haemodialysis patients. A higher level of training intensity or combination with resistance exercises may be required to further improve anabolism and influence muscle architecture in this patient population.

Clinical trial registry number: NCT03905551.

Keywords: End-stage renal disease; Intradialytic exercise; Muscle atrophy; Skeletal muscle architecture.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Exercise
  • Exercise Therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quadriceps Muscle / diagnostic imaging*
  • Quadriceps Muscle / physiology*
  • Renal Dialysis*
  • Time Factors
  • Ultrasonography

Associated data

  • ClinicalTrials.gov/NCT03905551