The Effect of Interdialytic Combined Resistance and Aerobic Exercise Training on Health Related Outcomes in Chronic Hemodialysis Patients: The Tunisian Randomized Controlled Study.

Journal: Frontiers in physiology

Volume: 8

Issue: 

Year of Publication: 

Affiliated Institutions:  Department of Biochemistry, Human Nutrition and Metabolic Disorders, Functional Foods and Vascular Health (LRES), Faculty of Medicine of Monastir, University of MonastirMonastir, Tunisia. Institut du Savoir Montfort-Recherche, Hôpital MontfortOttawa, ON, Canada. Department of Research, Exercise Physiology and Pathophysiology, Biology, Medicine and Health (URES), Faculty of Medicine of Sousse, University of MonastirSousse, Tunisia. Department of Physical Medicine and Rehabilitation, CHU Fatuma Bourguiba MonastirMonastir, Tunisia. Nephrology and Internal Medicine Service, CHU Fatuma Bourguiba MonastirMonastir, Tunisia.

Abstract summary 

Tunisia has the highest prevalence of hemodialysis patients compared to the other countries in North Africa. Dialysis centers rarely offer an exercise program to prevent physiological and psychological dialysis therapy-related alterations in chronic hemodialysis patients. To examine the effect of combined endurance-resistance training program on physiological and psychological outcomes in patients undergoing hemodialysis. We designed a single blinded, randomized, controlled study for a period of 4 months. Patients were randomized to intervention group or control group. Intervention group patients received 4 training sessions per week, held on non-hemodialysis days for a period of 4 months, whereas control group patients continued their regular lifestyle practice without direct intervention from the personnel of this investigation. Patients were evaluated at baseline (initial assessment) and after the four-month study period (final assessment) by the same investigator blinded to treatment group assignment using physical, physiological, and psychological measurements. Compared with control group, intervention group showed significant improvement in physical performance during the sit-to-stand-to-sit tests (STS-10: -16.2%, ES = -1.65; STS-60: +23.43%, ES = 1.18), handgrip force task (+23.54%, ES = 1.16), timed up and go test (-13.86%, ES = -1.13), and 6-min walk test (+15.94%, ES = 2.09). Likewise, mini nutritional assessment long form scores after intervention period were significantly higher in the intervention group compared to the control group (ES = 1.43). Physical and mental component scores of SF-36 questionnaire increased significantly in the intervention group (ES = 1.10 and ES = 2.06, respectively), whereas hospital anxiety and depression scale scores decreased significantly (ES = -1.65 and ES = -2.72, respectively). Regarding biological parameters, intervention group displayed improvement in systolic and diastolic blood pressures (ES = -2.77 and ES = -0.87, respectively), HDL-cholesterol, LDL-cholesterol, and triglycerides systematic levels (ES = 1.15, ES = -0.98, and ES = -1.01, respectively); however no significant effect of intervention period was observed on C-reactive protein, hemoglobin, albumin, and total cholesterol levels ( > 0.05). The current study showed that combined endurance-resistance training program had a beneficial effect on physical capacity and quality of life in chronic hemodialysis patients.

Authors & Co-authors:  Frih Bechir B Jaafar Hamdi H Mkacher Wajdi W Ben Salah Zohra Z Hammami Mohamed M Frih Ameur A

Study Outcome 

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Statistics
Citations :  Abdel-Rahman E. M., Yan G., Turgut F., Balogun R. A. (2011). Long-term morbidity and mortality related to falls in hemodialysis patients: role of age and gender - a pilot study. Nephron Clin. Pract. 118, c278–c284. 10.1159/000322275
Authors :  6
Identifiers
Doi : 288
SSN : 1664-042X
Study Population
Male,Female
Mesh Terms
Other Terms
exercise;hemodialysis;physical capacity;physiological responses;psychological responses
Study Design
Randomized Control Trial,Case Control Trial,Cross Sectional Study
Study Approach
Systemic Review
Country of Study
Tunisia
Publication Country
Switzerland