Comparison Of Supervised And Home Based Exercise Training Programs In Hemodialysis Patients

Abstract

PURPOSE: To compare the effects of supervised and home based exercise training on functional capacity, physical functioning, pulse wave velocity, self-reported health and physical activity in hemodialysis patients. METHODS: Forty maintenance hemodialysis patients were randomized to receive either supervised cycle training during dialysis (S), a home based walking program (H) or usual care (C). The goals of the training programs were to complete three sessions per week and eventually be exercising for 45 minutes per session at an RPE of 13. RESULTS: After three months, twenty seven patients (males=16, mean±SD, age=52±12yrs, BMI=29±9) remained in the study (S=8, H=9, C=10). Training compliance over the three months was S=90% and H=80% in the remaining patients. There were no significant (P>0.05) time or group differences in pre to post changes in six minute walk time (S=[up arrow]13%, H= S=[up arrow]5%, C= [up arrow]12%), get-up-and-go time (S= [down arrow]l%, H= [up arrow] 2%, C=s [down arrow]9%), pulse wave velocity (S= [up arrow]8%, H=> [up arrow]l2%, C=s [up arrow]3%), self reported mental (S= [down arrow]6%, H= [up arrow]6, C=[up arrow]4%) and physical health (S=> [down arrow]l4%, H= [up arrow]7%, C=[up arrow] [down arrow]1%). Of interest was the finding that increases in health enhancing physical activity levels (including time spent training) were not different between groups (S=[up arrow]400%, H=[up arrow]500%, C=[up arrow]200%). CONCLUSIONS: After three months, there were no differences in functional capacity, physical functioning, pulse wave velocity and self-reported health in hemodialysis patients randomized to supervised cycle training, home based walking or usual care. An increase in physical activity levels in the usual care patients may explain the unexpected lack of differences between these and the exercising patients.