Effect of Resistance Exercises on the Indicators of Muscle Reserves and Handgrip Strength in Adult Patients on Hemodialysis.
OBJECTIVE
Although resistance exercise has been associated with improvement in the muscle reserves, muscle strength and quality of life in end-stage renal disease patients, the objective of this paper is to evaluate the effect of resistance exercise performed during hemodialysis sessions on the anthropometric indicators of muscle reserve and handgrip strength in sedentary malnourished patients with end-stage renal disease.


METHODS
Patients were randomized to perform resistance exercise during hemodialysis sessions with ankle weights and resistance bands. The exercises were performed twice a week over the course of 12 weeks. The control group underwent a hemodialysis session alone. The outcomes measures were the following anthropometric measurements: arm muscle circumference and arm muscle area. Dynamometry was used to measure the handgrip strength.


RESULTS
Sixty-one sedentary patients with a median age of 29 years (interquartile range [IQR] 21-39 years), and 83% presenting with some grade of malnutrition were equally randomized to either the intervention or control group. In the resistance exercise group, there was an increase in the arm muscle circumference from 233.6 (IQR 202-254) mm to 241.4 (IQR 203-264) mm (P= .001), arm muscle area from 35.9 (26-41) cm(2) to 36.6 (IQR 26-46) cm(2) (P= .002), and handgrip strength from 19.6 (IQR 11-28) kg to 21.2 (IQR 13-32) kg between the basal and final measurements (P < .05). The tolerance to exercise was adequate, and no adverse events were reported during the practical exercise.


CONCLUSIONS
Resistance exercise at least twice a week is safe and represents an opportunity for improving the muscle mass and strength in adult patients who are on hemodialysis, including in those with malnutrition.
Master's and Doctorate Program in Health Sciences, Universidad Nacional Autónoma de México, México City, México.
Ma Guadalupe
MG
Olvera-Soto
Department of Nephrology, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, México.
Rafael
R
Valdez-Ortiz
Department of Investigation, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, México.
Juan Carlos
JC
López Alvarenga
Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México. Electronic address: angeles.espinosac@quetzal.innsz.mx.
María de Los Ángeles
Mde L
Espinosa-Cuevas
D000328:Adult; D015992:Body Mass Index; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000628:therapy; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D011788:Quality of Life; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000628:therapy; D055070:Resistance Training; D016896:Treatment Outcome; D055815:Young Adult