title: Benefits of exercise training during hemodialysis sessions: a prospective cohort study.
abstract: BACKGROUND
  End-stage renal disease patients can be considered as 'cardiovascular time bombs' due to their tremendous cardiovascular risk. Our study has determined the impact of 3 months of exercise training during dialysis on some of the cardiovascular risk factors (arterial stiffness, body composition and physical performance) in a chronic hemodialyzed population.
  
  
  METHODS
  The study group (n = 19) and control group (n = 16) of chronic hemodialysis patients from Timisoara, Romania, were enrolled in a prospective cohort study. The intervention--40 min of exercise training (with non-fistula hand and both lower limbs) during each hemodialysis session for 3 months--was applied only to the study group. The measurements made before and after intervention were aortic pulse wave velocity (PWV), aortic augmentation index, return time and both central and peripheral blood pressure for arterial stiffness evaluation, using the Arteriograph Tensiomed system, body composition by multifrequency bioimpedance and physical performance (Myotest PRO system and hand dynamometer).
  
  
  RESULTS
  We found a significant 1-m/s reduction in PWV, a 12-second increase in return time and a 10-mm Hg reduction in both central and systolic blood pressure driven only by the exercise training. Exercise training significantly increased the skeletal muscle mass and the soft lean mass of the study group patients. Physical performance significantly improved in the study group jumping height by 1 cm, lower limbs explosive power by 3 W/kg and non-fistula hand strength prehension by 0.06 bar.
  
  
  CONCLUSIONS
  Exercise training during dialysis has a positive effect on arterial stiffness, body composition and physical performance of chronic hemodialyzed patients.
authors.affiliation: Nephrology Department, 'V. Babes' University of Medicine and Pharmacy, Timisoara, Romania.
authors.forename: Adelina
authors.initials: A
authors.lastname: Mihaescu
authors.forename: Claudiu
authors.initials: C
authors.lastname: Avram
authors.forename: Flaviu
authors.initials: F
authors.lastname: Bob
authors.forename: Dan
authors.initials: D
authors.lastname: Gaita
authors.forename: Oana
authors.initials: O
authors.lastname: Schiller
authors.forename: Adalbert
authors.initials: A
authors.lastname: Schiller
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D016896:Treatment Outcome