nach oben

International Urology and Nephrology

Erschienen in:

23.01.2018 | Nephrology - Original Paper

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

verfasst von: Ji-Hyung Cho, Ji-Yeon Lee, Sukyung Lee, Hyuntae Park, Seung-Wook Choi, Jun Chul Kim

Erschienen in: International Urology and Nephrology | Ausgabe 4/2018

Einloggen, um Zugang zu erhalten

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.

Johansen KL, Chertow GM, Ng AV, Mulligan K, Carey S, Schoenfeld PY, Kent-Braun JA (2000) Physical activity levels in patients on hemodialysis and healthy sedentary controls. Kidney Int 57(6):2564–2570. https://doi.org/10.1046/j.1523-1755.2000.00116.x CrossRefPubMed

Kim JC, Shapiro BB, Zhang M, Li Y, Porszasz J, Bross R, Feroze U, Upreti R, Kalantar-Zadeh K, Kopple JD (2014) Daily physical activity and physical function in adult maintenance hemodialysis patients. J Cachexia Sarcopenia Muscle 5(3):209–220. https://doi.org/10.1007/s13539-014-0131-4 CrossRefPubMedCentralPubMed

Kosmadakis GC, Bevington A, Smith AC, Clapp EL, Viana JL, Bishop NC, Feehally J (2010) Physical exercise in patients with severe kidney disease. Nephron Clin Pract 115(1):c7–c16. https://doi.org/10.1159/000286344 CrossRefPubMed

Tawney KW, Tawney PJ, Kovach J (2003) Disablement and rehabilitation in end-stage renal disease. Semin Dial 16(6):447–452CrossRefPubMed

O’Hare AM, Tawney K, Bacchetti P, Johansen KL (2003) Decreased survival among sedentary patients undergoing dialysis: results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis 41(2):447–454. https://doi.org/10.1053/ajkd.2003.50055 CrossRefPubMed

Stack AG, Molony DA, Rives T, Tyson J, Murthy BV (2005) Association of physical activity with mortality in the US dialysis population. Am J Kidney Dis 45(4):690–701CrossRefPubMed

Lopes AA, Lantz B, Morgenstern H, Wang M, Bieber BA, Gillespie BW, Li Y, Painter P, Jacobson SH, Rayner HC, Mapes DL, Vanholder RC, Hasegawa T, Robinson BM, Pisoni RL (2014) Associations of self-reported physical activity types and levels with quality of life, depression symptoms, and mortality in hemodialysis patients: the DOPPS. Clin J Am Soc Nephrol 9(10):1702–1712. https://doi.org/10.2215/CJN.12371213 CrossRefPubMedCentralPubMed

Gusbeth-Tatomir P, Boisteanu D, Seica A, Buga C, Covic A (2007) Sleep disorders: a systematic review of an emerging major clinical issue in renal patients. Int Urol Nephrol 39(4):1217–1226. https://doi.org/10.1007/s11255-007-9262-2 CrossRefPubMed

Merlino G, Piani A, Dolso P, Adorati M, Cancelli I, Valente M, Gigli GL (2006) Sleep disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transplant 21(1):184–190. https://doi.org/10.1093/ndt/gfi144 CrossRefPubMed

10.

Razeghi E, Sahraian MA, Heidari R, Bagherzadeh M (2012) Association of inflammatory biomarkers with sleep disorders in hemodialysis patients. Acta Neurol Belg 112(1):45–49. https://doi.org/10.1007/s13760-012-0003-7 CrossRefPubMed

11.

Shayamsunder AK, Patel SS, Jain V, Peterson RA, Kimmel PL (2005) Sleepiness, sleeplessness, and pain in end-stage renal disease: distressing symptoms for patients. Semin Dial 18(2):109–118. https://doi.org/10.1111/j.1525-139X.2005.18218.x CrossRefPubMed

12.

Koch BC, Nagtegaal JE, Kerkhof GA, ter Wee PM (2009) Circadian sleep-wake rhythm disturbances in end-stage renal disease. Nat Rev Nephrol 5(7):407–416. https://doi.org/10.1038/nrneph.2009.88 CrossRefPubMed

13.

Novak M, Shapiro CM, Mendelssohn D, Mucsi I (2006) Diagnosis and management of insomnia in dialysis patients. Semin Dial 19(1):25–31. https://doi.org/10.1111/j.1525-139X.2006.00116.x CrossRefPubMed

14.

Elias RM, Chan CT, Paul N, Motwani SS, Kasai T, Gabriel JM, Spiller N, Bradley TD (2013) Relationship of pharyngeal water content and jugular volume with severity of obstructive sleep apnea in renal failure. Nephrol Dial Transplant 28(4):937–944. https://doi.org/10.1093/ndt/gfs473 CrossRefPubMed

15.

Elder SJ, Pisoni RL, Akizawa T, Fissell R, Andreucci VE, Fukuhara S, Kurokawa K, Rayner HC, Furniss AL, Port FK, Saran R (2008) Sleep quality predicts quality of life and mortality risk in haemodialysis patients: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 23(3):998–1004. https://doi.org/10.1093/ndt/gfm630 CrossRefPubMed

16.

Johansen KL (2007) Exercise in the end-stage renal disease population. J Am Soc Nephrol 18(6):1845–1854. https://doi.org/10.1681/ASN.2007010009 CrossRefPubMed

17.

Heiwe S, Jacobson SH (2014) Exercise training in adults with CKD: a systematic review and meta-analysis. Am J Kidney Dis 64(3):383–393. https://doi.org/10.1053/j.ajkd.2014.03.020 CrossRefPubMed

18.

Tentori F, Elder SJ, Thumma J, Pisoni RL, Bommer J, Fissell RB, Fukuhara S, Jadoul M, Keen ML, Saran R, Ramirez SP, Robinson BM (2010) Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes. Nephrol Dial Transplant 25(9):3050–3062. https://doi.org/10.1093/ndt/gfq138 CrossRefPubMed

19.

Parsons TL, Toffelmire EB, King-VanVlack CE (2006) Exercise training during hemodialysis improves dialysis efficacy and physical performance. Arch Phys Med Rehabil 87(5):680–687. https://doi.org/10.1016/j.apmr.2005.12.044 CrossRefPubMed

20.

Konstantinidou E, Koukouvou G, Kouidi E, Deligiannis A, Tourkantonis A (2002) Exercise training in patients with end-stage renal disease on hemodialysis: comparison of three rehabilitation programs. J Rehabil Med 34(1):40–45CrossRefPubMed

21.

Barcellos FC, Santos IS, Umpierre D, Bohlke M, Hallal PC (2015) Effects of exercise in the whole spectrum of chronic kidney disease: a systematic review. Clin Kidney J 8(6):753–765. https://doi.org/10.1093/ckj/sfv099 CrossRefPubMedCentralPubMed

22.

Sheng K, Zhang P, Chen L, Cheng J, Wu C, Chen J (2014) Intradialytic exercise in hemodialysis patients: a systematic review and meta-analysis. Am J Nephrol 40(5):478–490. https://doi.org/10.1159/000368722 CrossRefPubMed

23.

Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40(5):373–383CrossRefPubMed

24.

Steiber AL, Kalantar-Zadeh K, Secker D, McCarthy M, Sehgal A, McCann L (2004) Subjective global assessment in chronic kidney disease: a review. J Ren Nutr 14(4):191–200CrossRefPubMed

25.

Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMed

26.

Beck AT, Steer RA, Ball R, Ranieri W (1996) Comparison of Beck depression inventories-IA and -II in psychiatric outpatients. J Pers Assess 67(3):588–597. https://doi.org/10.1207/s15327752jpa6703_13 CrossRefPubMed

27.

Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14(5):377–381CrossRefPubMed

28.

Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40(1):181–188. https://doi.org/10.1249/mss.0b013e31815a51b3 CrossRefPubMed

29.

Sasaki JE, John D, Freedson PS (2011) Validation and comparison of ActiGraph activity monitors. J Sci Med Sport 14(5):411–416. https://doi.org/10.1016/j.jsams.2011.04.003 CrossRefPubMed

30.

Cole RJ, Kripke DF, Gruen W, Mullaney DJ, Gillin JC (1992) Automatic sleep/wake identification from wrist activity. Sleep 15(5):461–469CrossRefPubMed

31.

Faul F, Erdfelder E, Lang AG, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–191CrossRefPubMed

32.

Koh KP, Fassett RG, Sharman JE, Coombes JS, Williams AD (2010) Effect of intradialytic versus home-based aerobic exercise training on physical function and vascular parameters in hemodialysis patients: a randomized pilot study. Am J Kidney Dis 55(1):88–99. https://doi.org/10.1053/j.ajkd.2009.09.025 CrossRefPubMed

33.

Saitoh M, Ogawa M, Dos Santos MR, Kondo H, Suga K, Itoh H, Tabata Y (2016) Effects of intradialytic resistance exercise on protein energy wasting, physical performance and physical activity in ambulatory patients on dialysis: a Single-Center Preliminary Study in a Japanese Dialysis Facility. Ther Apher Dial 20(6):632–638. https://doi.org/10.1111/1744-9987.12447 CrossRefPubMed

34.

Molnar MZ, Novak M, Mucsi I (2006) Management of restless legs syndrome in patients on dialysis. Drugs 66(5):607–624CrossRefPubMed

35.

Koch BC, Nagtegaal JE, Hagen EC, van der Westerlaken MM, Boringa JB, Kerkhof GA, Ter Wee PM (2009) The effects of melatonin on sleep-wake rhythm of daytime haemodialysis patients: a randomized, placebo-controlled, cross-over study (EMSCAP study). Br J Clin Pharmacol 67(1):68–75. https://doi.org/10.1111/j.1365-2125.2008.03320.x CrossRefPubMedCentralPubMed

36.

Sabbatini M, Crispo A, Pisani A, Ragosta A, Cesaro A, Mirenghi F, Cianciaruso B, Federico S (2003) Zaleplon improves sleep quality in maintenance hemodialysis patients. Nephron Clin Pract 94(4):c99–c103. https://doi.org/10.1159/000072493 CrossRefPubMed

37.

Yang B, Xu J, Xue Q, Wei T, Xu J, Ye C, Mei C, Mao Z (2015) Non-pharmacological interventions for improving sleep quality in patients on dialysis: systematic review and meta-analysis. Sleep Med Rev 23:68–82. https://doi.org/10.1016/j.smrv.2014.11.005 CrossRefPubMed

38.

Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW (2015) The effects of physical activity on sleep: a meta-analytic review. J Behav Med 38(3):427–449. https://doi.org/10.1007/s10865-015-9617-6 CrossRefPubMed

39.

Ferris LT, Williams JS, Shen CL, O’Keefe KA, Hale KB (2005) Resistance training improves sleep quality in older adults a pilot study. J Sports Sci Med 4(3):354–360PubMedCentralPubMed

40.

Uchida S, Shioda K, Morita Y, Kubota C, Ganeko M, Takeda N (2012) Exercise effects on sleep physiology. Front Neurol 3:48. https://doi.org/10.3389/fneur.2012.00048 CrossRefPubMedCentralPubMed

41.

Afshar R, Emany A, Saremi A, Shavandi N, Sanavi S (2011) Effects of intradialytic aerobic training on sleep quality in hemodialysis patients. Iran J Kidney Dis 5(2):119–123PubMed

42.

Giannaki CD, Hadjigeorgiou GM, Karatzaferi C, Maridaki MD, Koutedakis Y, Founta P, Tsianas N, Stefanidis I, Sakkas GK (2013) A single-blind randomized controlled trial to evaluate the effect of 6 months of progressive aerobic exercise training in patients with uraemic restless legs syndrome. Nephrol Dial Transplant 28(11):2834–2840. https://doi.org/10.1093/ndt/gft288 CrossRefPubMed

43.

Parker KP (2003) Sleep disturbances in dialysis patients. Sleep Med Rev 7(2):131–143CrossRefPubMed

44.

Kimmel PL, Cukor D, Cohen SD, Peterson RA (2007) Depression in end-stage renal disease patients: a critical review. Adv Chronic Kidney Dis 14(4):328–334. https://doi.org/10.1053/j.ackd.2007.07.007 CrossRefPubMed

45.

Theofilou P (2013) Association of insomnia symptoms with kidney disease quality of life reported by patients on maintenance dialysis. Psychol Health Med 18(1):70–78. https://doi.org/10.1080/13548506.2012.674144 CrossRefPubMed

46.

Ouzouni S, Kouidi E, Sioulis A, Grekas D, Deligiannis A (2009) Effects of intradialytic exercise training on health-related quality of life indices in haemodialysis patients. Clin Rehabil 23(1):53–63. https://doi.org/10.1177/0269215508096760 CrossRefPubMed

47.

Kouidi E, Karagiannis V, Grekas D, Iakovides A, Kaprinis G, Tourkantonis A, Deligiannis A (2010) Depression, heart rate variability, and exercise training in dialysis patients. Eur J Cardiovasc Prev Rehabil 17(2):160–167. https://doi.org/10.1097/HJR.0b013e32833188c4 CrossRefPubMed

48.

Godfrey A, Conway R, Meagher D, ÓLaighin G (2008) Direct measurement of human movement by accelerometry. Med Eng Phys 30(10):1364–1386. https://doi.org/10.1016/j.medengphy.2008.09.005 CrossRefPubMed

49.

Morgenthaler T, Alessi C, Friedman L, Owens J, Kapur V, Boehlecke B, Brown T, Chesson A Jr, Coleman J, Lee-Chiong T, Pancer J, Swick TJ, Standards of Practice C, American Academy of Sleep M (2007) Practice parameters for the use of actigraphy in the assessment of sleep and sleep disorders: an update for 2007. Sleep 30(4):519–529CrossRefPubMed

50.

Haskell WL (2012) Physical activity by self-report: a brief history and future issues. J Phys Act Health 9(Suppl 1):S5–S10CrossRefPubMed

51.

Sadeh A (2011) The role and validity of actigraphy in sleep medicine: an update. Sleep Med Rev 15(4):259–267. https://doi.org/10.1016/j.smrv.2010.10.001 CrossRefPubMed

52.

Fonseca NT, Urbano JJ, Nacif SR, Silva AS, Peixoto RA, Urbano GJ, Oliveira EF, Santos IR, Oliveira CS, Insalaco G, Oliveira LV (2016) A systematic review of sleep disorders in patients with chronic kidney disease undergoing hemodialysis. J Phys Ther Sci 28(7):2164–2170. https://doi.org/10.1589/jpts.28.2164 CrossRefPubMedCentralPubMed

53.

Kushida CA, Littner MR, Morgenthaler T, Alessi CA, Bailey D, Coleman J Jr, Friedman L, Hirshkowitz M, Kapen S, Kramer M, Lee-Chiong T, Loube DL, Owens J, Pancer JP, Wise M (2005) Practice parameters for the indications for polysomnography and related procedures: an update for 2005. Sleep 28(4):499–521CrossRefPubMed

54.

Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, Zucconi M, Ferri R, Trenkwalder C, Lee HB, International Restless Legs Syndrome Study G (2014) Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Med 15(8):860–873. https://doi.org/10.1016/j.sleep.2014.03.025 CrossRefPubMed

Titel: Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients
verfasst von: Ji-Hyung Cho
Ji-Yeon Lee
Sukyung Lee
Hyuntae Park
Seung-Wook Choi
Jun Chul Kim
Publikationsdatum: 23.01.2018
Verlag: Springer Netherlands
Erschienen in: International Urology and Nephrology / Ausgabe 4/2018
Print ISSN: 0301-1623
Elektronische ISSN: 1573-2584
DOI: https://doi.org/10.1007/s11255-018-1796-y

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 4/2018

Inhibiting autophagy overcomes docetaxel resistance in castration-resistant prostate cancer cells

Effect of restricted protein diet supplemented with keto analogues in end-stage renal disease: a systematic review and meta-analysis

Visual internal urethrotomy for management of urethral strictures in boys: a comparison of short-term outcome of holmium laser versus cold knife

Effects of metformin on prostatic tissue of rats with metabolic syndrome and benign prostatic hyperplasia

Impact of low-dose steroids on HbA1c levels and development of pre-diabetes and NODAT in non-diabetic renal transplant recipients on long-term follow-up