title: Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: a prospective randomized trial.
abstract: BACKGROUND
  Individuals on hemodialysis have low physical function and activity levels. Clinical trials have shown improvements in these parameters with exercise programming. Pedometers have not been extensively evaluated in individuals on hemodialysis. This randomized clinical trial compared the effects of intradialytic cycling versus a pedometer program on physical function, physical activity and quality of life.
  
  
  METHODS
  Sixty patients were randomly assigned to two study groups. The ergometer group cycled during each hemodialysis session for 24 weeks. Pedometer participants followed a home-based walking program for 24 weeks. The primary outcome was aerobic capacity [VO2peak and 6-minute walk (6MW) test]. Secondary outcomes included lower extremity strength [sit-to-stand (SS) test], flexibility [sit-and-reach (SR) test], physical activity (accelerometer) and health-related quality of life. Measurements were collected at baseline and at 12 and 24 weeks.
  
  
  RESULTS
  At 12 and 24 weeks, there was no significant change in the VO2peak or 6MW test between or within study groups. SS testing in the ergometer group improved from 10.2 (SD 3.4) to 11.4 (SD 2.5) cycles from baseline to 24 weeks (P < 0.005). Similarly, in the pedometer group, SS cycles improved from 10.1 (SD 3.3) to 12.2 (SD 3.5) (P < 0.005). The SR test also significantly improved over time in both the study groups. No significant changes were noted for other secondary outcomes.
  
  
  CONCLUSIONS
  Both intradialytic cycling and pedometer programming improved aspects of physical function. Neither intervention had a significant effect on aerobic capacity. No significant differences in any outcomes were identified between interventions groups.
authors: Section of Nephrology, University of Manitoba, Winnipeg, MB, Canada.
authors: Clara
authors: C
authors: Bohm
authors: Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
authors: Krista
authors: K
authors: Stewart
authors: Winnipeg Regional Health Authority, Winnipeg, MB, Canada.
authors: Jennifer
authors: J
authors: Onyskie-Marcus
authors: Loughborough University, Leicestershire, UK.
authors: Dale
authors: D
authors: Esliger
authors: School of Medical Rehabilitation, University of Manitoba, Winnipeg, MB, Canada.
authors: Dean
authors: D
authors: Kriellaars
authors: Section of Nephrology, University of Manitoba, Winnipeg, MB, Canada.
authors: Claudio
authors: C
authors: Rigatto
mesh_terms: D000203:Activities of Daily Living; D001642:Bicycling; D016552:Ergometry; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010045:Outpatients; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis / Q000379:methods*; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy; D016138:Walking
keywords: exercise; hemodialysis; pedometers; physical activity; physical function