title: Acute and long-term effects of an exercise program for dialysis patients prescribed in hospital and performed at home.
abstract: BACKGROUND
  Exercise has positive psychophysical effects on dialysis patients, thus effective programs should be identified. We evaluated the effects of an original 6-month walking program on physical capacity, health-related quality of life (HRQL) and postdialysis fatigue (PDF).
  
  
  METHODS
  Thirty-one dialysis patients (19 male, mean age 65 -/+ 11 years) were divided into exercise (group E; n=17) and control (group C; n=14) groups, and evaluated upon entry, after the 6-month program and 19 -/+ 3 months later. Outcome measures were 6-minute walking distance (6MWD), SF-36 scale scores, self-reported PDF and recovery time. E group was assigned 2 daily 10-minute home walking sessions on the nondialysis day at a speed 50% below maximal treadmill speed as determined and updated monthly at the hospital. C group: no exercise.
  
  
  RESULTS
  Twenty patients (13 from E, 7 from C) completed the study. The E group, unlike the C group, increased 6MWD (308 -/+ 105 m, to 351 -/+ 118 m, p=0.0007), and HRQL, significantly for bodily pain, physical role and mental health (p<0.05), decreased PDF and recovery time (p<0.05). At the follow-up, 15 patients were reevaluated (9 from E, 6 from C). The E group was still active and showed 6MWD similar to baseline, with a decline of 0.13 -/+ 1.72 m/mo. The C group decreased 6MWD (p=0.026) with a decline of 3.43 -/+ 3.2 m/mo. For both groups, HRQL, PDF and recovery time showed slight variations from baseline.
  
  
  CONCLUSIONS
  In dialysis patients, a 6-month exercise program prescribed at the hospital and performed at home improved physical capacity, HRQL and PDF symptoms. Patients maintained an active lifestyle after discharge and showed a slow functional decline over a 2-year period.
authors.affiliation: Vascular Diseases Center, University of Ferrara, Ferrara - Italy. mlgnmr@unife.it
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Malagoni
authors.forename: Luigi
authors.initials: L
authors.lastname: Catizone
authors.forename: Simona
authors.initials: S
authors.lastname: Mandini
authors.forename: Silvia
authors.initials: S
authors.lastname: Soffritti
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
authors.forename: Benedetta
authors.initials: B
authors.lastname: Boari
authors.forename: Giorgia
authors.initials: G
authors.lastname: Russo
authors.forename: Nino
authors.initials: N
authors.lastname: Basaglia
authors.forename: Paolo
authors.initials: P
authors.lastname: Zamboni
authors.forename: Fabio
authors.initials: F
authors.lastname: Manfredini
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology