Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial

Rossella Baggetta, Graziella D'Arrigo, Claudia Torino, Samar Abd ElHafeez, Fabio Manfredini, Francesca Mallamaci, Carmine Zoccali, Giovanni Tripepi, EXCITE Working group, Davide Bolignano, Nicola Lamberti, Silvio Bertoli, Daniele Ciurlino, Lisa Rocca-Rey, Antonio Barillà, Yuri Battaglia, Renato Mario Rapanà, Alessandro Zuccalà, Graziella Bonanno, Pasquale Fatuzzo, Francesco Rapisarda, Stefania Rastelli, Fabrizio Fabrizi, Piergiorgio Messa, Luciano De Paola, Luigi Lombardi, Adamasco Cupisti, Giorgio Fuiano, Gaetano Lucisano, Chiara Summaria, Michele Felisatti, Enrico Pozzato, Anna Maria Malagoni, Pietro Castellino, Filippo Aucella, Pasquale Fabio Provenzano, Luigi Catizone, Rossella Baggetta, Graziella D'Arrigo, Claudia Torino, Samar Abd ElHafeez, Fabio Manfredini, Francesca Mallamaci, Carmine Zoccali, Giovanni Tripepi, EXCITE Working group, Davide Bolignano, Nicola Lamberti, Silvio Bertoli, Daniele Ciurlino, Lisa Rocca-Rey, Antonio Barillà, Yuri Battaglia, Renato Mario Rapanà, Alessandro Zuccalà, Graziella Bonanno, Pasquale Fatuzzo, Francesco Rapisarda, Stefania Rastelli, Fabrizio Fabrizi, Piergiorgio Messa, Luciano De Paola, Luigi Lombardi, Adamasco Cupisti, Giorgio Fuiano, Gaetano Lucisano, Chiara Summaria, Michele Felisatti, Enrico Pozzato, Anna Maria Malagoni, Pietro Castellino, Filippo Aucella, Pasquale Fabio Provenzano, Luigi Catizone

Abstract

Background: Older adults dialysis patients represent the frailest subgroup of the End Stage Renal Disease (ESRD) population and physical exercise program may mitigate the age-related decline in muscle mass and function.

Methods: Dialysis patients of the EXCITE trial aged > 65 years (n = 115, active arm, n = 53; control arm, n = 62) were submitted in random order to a home based, low intensity physical exercise program. At baseline and 6 months after exercise training 6-min walking distance (6MWD) and 5-time sit-to-stand test (5STS) were performed, and quality of life (QoL) was tested.

Results: The training program improved both the 6MWD (6-months: 327 ± 86 m versus baseline: 294 ± 74 m; P < 0.001) and the 5STS time (6-months: 19.8 ± 5.6 s versus baseline: 22.5 ± 5.1 s; P < 0.001) in the exercise group whereas they did not change in the control group (P = 0.98 and 0.25, respectively). The between-arms differences (6 months-baseline) in the 6MWD (+ 34.0 m, 95% CI: 14.4 to 53.5 m) and in the 5STS time changes (- 1.9 s, 95% CI: -3.6 to - 0.3 s) were both statistically significant (P = 0.001 and P = 0.024, respectively). The cognitive function dimension of QoL significantly reduced in the control arm (P = 0.04) while it remained unchanged in the active arm (P = 0.78) (between groups difference P = 0.05). No patient died during the trial and the training program was well tolerated.

Conclusions: This secondary analysis of the EXCITE trial shows that a home-based, exercise program improves physical performance and is well tolerated in elderly ESRD patients.

Trial registration: The trial was registered in ClinicalTrials.Gov ( Clinicaltrials.gov identifier: NCT01255969) on December 8, 2010.

Keywords: Dialysis patients; Physical exercise; Quality of life.

Conflict of interest statement

Ethics approval and consent to participate

The original protocol of the EXCITE trial was approved by the Ethics Committees of Renal Units participating to the study, and written informed consent was obtained from each participant. The Ethical Committee of the Coordinating Center is that of “Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli” of Reggio Calabria, Italy (Committee’s reference number: CE150157). The trial was registered in Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CONSORT diagram describing the flow of patients through the trial

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