Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients

So Yon Rhee, Jin Kyung Song, Suk Chul Hong, Jae Won Choi, Hee Jung Jeon, Dong Ho Shin, Eun Hee Ji, Eun-Hee Choi, Jiyeon Lee, Aram Kim, Seung Wook Choi, Jieun Oh, So Yon Rhee, Jin Kyung Song, Suk Chul Hong, Jae Won Choi, Hee Jung Jeon, Dong Ho Shin, Eun Hee Ji, Eun-Hee Choi, Jiyeon Lee, Aram Kim, Seung Wook Choi, Jieun Oh

Abstract

Background/aims: As numbers of maintenance hemodialysis patients are growing, debilitating conditions of muscle wasting and atrophy are becoming some of the greatest concerns in end-stage renal disease patients. Exercise training has various potential benefits in terms of prevention of a sustained decline in functional status. This study aimed to evaluate the physical, psychological, laboratory, and dialysis-related effects of intradialytic exercise.

Methods: We enrolled 22 patients from a hemodialysis center for a 6-month non-randomized prospective trial. Combination of aerobic exercise with bicycle ergometer and anaerobic exercise with elastic bands was conducted during hemodialysis. Data including physical fitness test results, dialysis-related measurements, and biochemical laboratory results were collected at baseline, 3, and 6 months. Depression and quality of life were assessed using Beck Depression Inventory and Short Form-36 health survey.

Results: After exercise completion, there were significant improvements in back muscle power, forward and backward trunk flexibility, vertical jump, elbow flexion, sit to stand test, and 6-minute walk test (p < 0.05). No significant changes were observed in dry weight, blood pressure, Kt/V, and biochemical variables, except for intradialytic hypotension (p < 0.05). For depression, Beck Depression Inventory showed statistically significant enhancement (p < 0.05). Scores of Short Form-36 health survey did not show significant increase in each domain, except for bodily pain (p < 0.05).

Conclusion: Combined aerobic and anaerobic exercise training during dialysis was found to be effective on physical health status, intradialytic hypotension, and depression in terms of mental health. Therefore, the findings of the current study may provide an appropriate guidance for encouraging exercise by nephrologists.

Keywords: Depression; Intradialytic exercise; Intradialytic hypotension; Physical function; Renal dialysis.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
The pattern of blood pressure before, during and after exercise. (A) Intradialytic hypotension (+) group (n = 16) and (B) intradialytic hypotension (–) group (n = 6). Values are expressed as mean ± SD. SBP, systolic blood pressure; DBP, diastolic blood pressure.
Figure 2.
Figure 2.
The change of blood pressure during 6 months. (A) Systolic blood pressure and (B) diastolic blood pressure.

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