title: A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence.
abstract: OBJECTIVE
  Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce.
  
  
  METHODS
  A single-centre clinical trial, non-randomised, investigating 46 patients with HD (63.2 ± 16.3 years, male/female 24/22, dialysis vintage 4.4 years) performing an SPEP over 5 years. The SPEP (twice/week for 60 min during haemodialysis) consisted of a combined resistance (8 muscle groups) and endurance (supine bicycle ergometry) training. Exercise intensity was continuously adjusted to improvements of performance testing. Changes in endurance and resistance capacity, physical functioning and quality of life (QoL) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years. Average power per training session, maximal strength tests (maximal exercise repetitions/min), three performance-based tests for physical function, SF36 for QoL were assessed in the beginning and every 6 months thereafter.
  
  
  RESULTS
  78% of the patients completed the programme after 1 year and 43% after 5 years. Participants were divided--according to adherence to the programme--into three groups: (1) high adherence group (HA, >80% of 104 training sessions within 12 months), (2) moderate adherence (MA, 60-80%), and 3. Low adherence group (LA, <60%)) with HA and MA evaluated quantitatively. One-year follow-up data revealed significant (p<0.05) improvement for both groups in all measured parameters: exercise capacity (HA: 55%, MA: 45%), strength (HA: >120%, MA: 40-50%), QoL in three scores of SF36 subscales and physical function in the three tests taken between 11% and 31%. Moreover, a quantitative correlation analysis revealed a close association (r=0.8) between large improvement of endurance capacity and weak physical condition (HA).
  
  
  CONCLUSIONS
  The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence.
authors: KfH Kidney Center, Bischofswerda, Germany ReNi-German Society of Sports Rehabilitation in CKD, Berlin, Germany.
authors: Kirsten
authors: K
authors: Anding
authors: KfH Kidney Center, Bischofswerda, Germany.
authors: Thomas
authors: T
authors: Bär
authors: KfH Kidney Center, Bischofswerda, Germany.
authors: Joanna
authors: J
authors: Trojniak-Hennig
authors: KfH Kidney Center, Bischofswerda, Germany.
authors: Simone
authors: S
authors: Kuchinke
authors: ReNi-German Society of Sports Rehabilitation in CKD, Berlin, Germany.
authors: Rolfdieter
authors: R
authors: Krause
authors: Max Planck-Institute for the Physics of Complex Systems, Dresden, Germany PULSE Institute, Stanford University, Palo Alto, USA.
authors: Jan M
authors: JM
authors: Rost
authors: Department of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der, Isar, Technische Universität München, Munich, Germany Partner site Munich Heart Alliance, DZHK (German Center for Cardiovascular Research), Munich, Germany Else-Kröner-Fresenius-Zentrum, Munich, Germany.
authors: Martin
authors: M
authors: Halle
mesh_terms: D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D053580:Muscle Strength; D010349:Patient Compliance; D010807:Physical Endurance; D011788:Quality of Life; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000628:therapy*; D055070:Resistance Training; D016896:Treatment Outcome
keywords: Dialysis < NEPHROLOGY; SPORTS MEDICINE