Intradialytic resistance training improves functional capacity and lean mass gain in hemodialysis patients: a randomized pilot trial

Publication date: Available online 3 July 2019

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Lorena Cristina Curado Lopes, João Felipe Mota, Jonato Prestes, Raquel Machado Schincaglia, Debora Mendes Silva, Nayara Pedatella Queiroz, Ana Tereza Vaz de Souza Freitas, Fábio dos Santos Lira, Gondim Peixoto Maria do Rosário

ABSTRACT

Objective

To compare the effects of high versus moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in hemodialysis patients.

Design

A pilot randomized clinical trial.

Setting

Two hemodialysis centers.

Participants

80 hemodialysis patients (51% of males, aged 30 -75 years old) in treatment for at least three months, adequately dialyzed (Kt/V ≥ 1.2), vascular access for arteriovenous fistula.

Interventions

The 12 weeks intradialytic RT were performed three times per week. The training groups were: high-load intradialytic group (HLG, 8-10 repetitions), moderate-load intradialytic group (MLG, 16-18 repetitions), and control group (CG, stretching exercise). The total training volume was equalized among training groups.

Main outcome measures

Leg lean mass assessed by a dual-energy X-ray absorptiometry, functional capacity by short battery physical performance and time and go test, QoL by Kidney Disease QoL instrument, inflammatory markers, and sarcopenia.

Results

After the training period, the HLG increased leg lean mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention.

Conclusion

High-load intradialytic RT was associated with gains in leg lean mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load.

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