Intradialytic periodized exercise improves cardiopulmonary fitness and respiratory function: A randomized controlled trial

• Published in: Seminars in dialysis 2022-03, Vol.35 (2), p.181-189
• Main Authors: Andrade, Francini Porcher, Borba, Gabrielle Costa, Silva, Kacylen Costa, Ferreira, Tatiane de Souza, Oliveira, Samantha Gonçalves, Antunes, Verônica Verleine Hörbe, Veronese, Francisco Veríssimo, Rovedder, Paula Maria Eidt
• Format: Article
• Language: English
• Subjects: Exercise; Forced Expiratory Volume; Humans; Muscle Strength - physiology; Renal Dialysis - adverse effects; Respiratory Function Tests
• ISSN: 0894-0959; 1525-139X
• DOI: 10.1111/sdi.13020

Background Chronic kidney disease (CKD) is a factor that predisposes to gradual physical deconditioning from its early stages leading to cardiorespiratory fitness and musculoskeletal system impairment. We evaluated the effects of combined and periodized intradialytic exercise training on cardiopulmonary fitness and respiratory function in HD subjects. Methods A randomized controlled trial with HD subjects was allocated into two groups: exercise group (EXG) and usual care group (UCG). EXG performed a 12‐week combined and periodized intradialytic training. UCG maintained the HD routine. Results Thirty‐nine HD subjects were analyzed (EXG = 20; UCG = 19). The EXG in comparison with the UCG showed improvements in peak oxygen consumption (Δ3.1[0.4–5.5] vs. −0.2[−2.0–1.5] ml/kg/min; p = 0.003), forced expiratory volume in the first second (Δ0.1[−0.0–0.1] vs. −0.0[−0.1–0.0] L; p = 0.022), forced vital capacity (Δ0.1[0.0–0.2] vs. −0.1[−0.2–0.0] L; p = 0.005), peak expiratory flow (Δ0.4[−0.7–1.2] vs. −0.1[−0.5–0.2] L; p = 0.046), and maximal inspiratory pressure (Δ7.35[−8.5–17.5] vs. −4.0[−18.0–12.0] cmH2O; p = 0.028). The EXG, different from the UCG, did not worsen the maximal expiratory pressure (Δ0.1[−8.8–7.5] vs. −2.5[−15.0–9.0] cmH2O; p = 0.036). Besides, EXG showed a significant improvement in quadriceps strength (32.05 ± 10.61 vs. 33.35 ± 11.62 kg; p = 0.042). Conclusions The combined and periodized intradialytic exercise training improved cardiopulmonary fitness, respiratory function, inspiratory muscle strength, and quadriceps strength, beyond maintaining the expiratory muscle strength in HD subjects.