title: Complete low-intensity endurance training programme in haemodialysis patients: improving the care of renal patients.
abstract: BACKGROUND
  Patients on haemodialysis (HD) have a decreased physical and functional capacity. Several studies have reported the beneficial effects of exercise on the physical, functional and psychological functioning of HD patients. Despite these results, exercise programmes on HD are not commonplace.
  
  
  OBJECTIVE
  To analyse the effect of an intradialysis endurance training programme on muscular strength and functional capacity in our HD patients.
  
  
  METHODS
  A 6-month single-centre prospective study. HD patients were non-randomly assigned to an exercise group (group E) or a control group (group C). Exercise training included complete endurance training using balls, weights and elastic bands in the first 2 h of an HD session; group C received standard HD care. Analysed data: (1) biochemical parameters; (2) biceps and quadriceps muscle tone, maximum quadriceps length strength (MQLS) and dominant hand grip (HG); (3) functional capacity tests: sit-to-stand-to-sit (STS10) and 6-min walking test (6MWT).
  
  
  RESULTS
  Forty patients were included, 55% were men; their mean age was 68.4 years; the patients were 61.6 months on HD; 16 patients were in group E and 24 in group C. In group E, muscular strength showed a significant improvement in MQLS (15.6 ± 10.7 vs. 17.7 ± 12.5 kg, p < 0.05) and HG (22.1 ± 13.2 vs. 24.1 ± 15.8 kg, p < 0.05) at the end of the programme, while a global decrease was reported in group C (MQLS 20.9 ± 9.3 vs. 16.2 ± 8.4 kg, p < 0.05; HG 25.1 ± 10.3 vs. 24.1 ± 11.1 kg). 6MWT significantly improved in group E (20%, 293.1 vs. 368 m, p < 0.001) and decreased in group C (10%, 350 vs. 315 m, p < 0.004). At the end of the programme, STS10 time was reduced in group E (2.1 ± 18.5 vs. 28.7 ± 20.6 s), while it rose in group C (31.5 ± 17.9 vs. 36.4 ± 19.8 s), though significant differences were not found.
  
  
  CONCLUSIONS
  (1) The intradialysis training programme improved muscular strength and functional capacity in our HD patients. (2) These results support the benefits of exercise training for HD patients. (3) Nephrologists should consider exercise training as a standard practice for the care of HD patients.
authors.affiliation: Nephrology Department, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Spain.
authors.forename: Vicent
authors.initials: V
authors.lastname: Esteve Simó
authors.forename: Anna
authors.initials: A
authors.lastname: Junqué
authors.forename: Miquel
authors.initials: M
authors.lastname: Fulquet
authors.forename: Verónica
authors.initials: V
authors.lastname: Duarte
authors.forename: Anna
authors.initials: A
authors.lastname: Saurina
authors.forename: Mónica
authors.initials: M
authors.lastname: Pou
authors.forename: Fátima
authors.initials: F
authors.lastname: Moreno
authors.forename: Jose
authors.initials: J
authors.lastname: Carneiro
authors.forename: Manel
authors.initials: M
authors.lastname: Ramírez de Arellano
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000534:rehabilitation*; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D010807:Physical Endurance / Q000502:physiology; D011446:Prospective Studies; D006435:Renal Dialysis; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology