Home-based Aerobic Exercise and Resistance Training in Peritoneal Dialysis Patients: A Randomized Controlled Trial

Kiyotaka Uchiyama, Naoki Washida, Kohkichi Morimoto, Kaori Muraoka, Takahiro Kasai, Kentaro Yamaki, Kazutoshi Miyashita, Shu Wakino, Hiroshi Itoh, Kiyotaka Uchiyama, Naoki Washida, Kohkichi Morimoto, Kaori Muraoka, Takahiro Kasai, Kentaro Yamaki, Kazutoshi Miyashita, Shu Wakino, Hiroshi Itoh

Abstract

Potential effects of aerobic and resistance training in peritoneal dialysis (PD) patients have been partially elucidated. We investigated effects of a home-based exercise program on physical functioning and health-related quality of life (HRQOL) in PD patients. Patients were randomly assigned to exercise (n = 24) and usual care (n = 23) groups. The exercise patients performed aerobic exercise thrice weekly and resistance training twice weekly at home for 12 weeks. The usual care patients received no specific intervention. The distance in incremental shuttle walking test significantly improved in the exercise group compared with the usual care group (P = 0.02). Among the HRQOL subscales assessed using the Kidney Disease Quality of Life-Short Form questionnaire, kidney disease component summary (P = 0.03), physical role functioning (P = 0.01), emotional role functioning (P < 0.01), and role/social component summary (P < 0.01) significantly improved in the exercise group. Moreover, serum albumin was significantly maintained in the exercise group (P = 0.03). There were no reported adverse events associated with the intervention. To our knowledge, this is the first randomized controlled trial to indicate the beneficial effects of a 12-week home-based exercise program exclusively in PD patients.

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
CONSORT diagram of the flow of patients through the various phases of the trial.
Figure 2
Figure 2
Dose–response relationship between the achieved incremental shuttle walking test (ISWT) across the usual care group and low adherence and high adherence to the home-based aerobic exercise (AE) or resistance training (RT) in the exercise group. The bars represent the standard deviations of the means. High and low adherence to AE were defined as adherence to >50% and ≤50% of the prescribed AE sessions, respectively, and high and low adherence to RT were defined as adherence to >86% and ≤86% of the prescribed RT sessions, respectively.
Figure 3
Figure 3
Dose–response relationship between the achieved handgrip strength across the usual care group and low adherence and high adherence to the home-based aerobic exercise (AE) or resistance training (RT) in the exercise group. The bars represent the standard deviations of the means. High and low adherence to AE were defined as adherence to >50% and ≤50% of the prescribed AE sessions, respectively, and high and low adherence to RT were defined as adherence to >86% and ≤86% of the prescribed RT sessions, respectively.
Figure 4
Figure 4
Dose–response relationship between the achieved quadriceps strength across the usual care group and low adherence and high adherence to the home-based aerobic exercise (AE) or resistance training (RT) in the exercise group. The bars represent the standard deviations of the means. High and low adherence to AE were defined as adherence to >50% and ≤50% of the prescribed AE sessions, respectively, and high and low adherence to RT were defined as adherence to >86% and ≤86% of the prescribed RT sessions, respectively.

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