title: Benefits of a low intensity exercise programme during haemodialysis sessions in elderly patients.
abstract: BACKGROUND
  Elderly patients on haemodialysis (HD) are a steadily increasing group. They show a high complexity, dependency and comorbidity. Multiple benefits from exercise in HD patients have been reported; however, they have not been specifically evaluated in an elderly population.
  
  
  OBJECTIVE
  To assess the effect of an adapted low intensity intradialytic exercise programme on muscle strength, functional capacity and health-related quality of life in our elderly patients (> 80 years) on HD.
  
  
  METHODS
  HD patients were non-randomly assigned to an exercise training group (E) or a control group (C) in a 12-week single-centre prospective study. E included a combined exercise programme using balls, weights, elastic bands and cycle movements in the first 2 hours of HD sessions. C group patients received standard HD care. Endpoints were: 1) main biochemical data; 2) maximum quadriceps length strength (MQLS) and hand-grip (HG); 3) functional capacity tests: "Sit to stand to sit" (STS10) and "six-minutes walking test" (6MWT); 4) Beck Depressive Inventory (BDI); and 5) Health-related quality of life questionnaire: EuroQol-5D (EQ-5D).
  
  
  RESULTS
  A total of 22 patients were included (50% men). Mean age was 83.2 years; patients had received HD for 44.1 month. Charlson index was 9.5. Main aetiology was diabetes mellitus (36.4%). Eleven patients were assigned to E group and 11 to C group. No related adverse effects were observed. At the end of the study, E group showed an overall improvement in tests (*P<.05): MQLS 10.5 ± 7.6 vs. 12.9 ± 10.1 kg, HG* 16.6 ± 8.7 vs. 18.2 ± 8.9 kg, STS10* 29.9 ± 10.6 vs. 25 ± 7.87 sec, 6MWT* 14.6%, 234.4 vs. 274.7 m, BDI* 14.4 ± 11.5 vs. 11.7 ± 10.8 and EQ-5D 49 ± 19.1 vs. 59.5 ± 20.3. No similar changes were observed in C group. Significant differences between groups were also found for HG, MQLS, STS10, 6MWT, BDI and EQ-5D. No significant changes were found in biochemical and anthropometric data, antidepressant treatment or suitable dialysis parameters at the end of the study.
  
  
  CONCLUSIONS
  1) An adapted low intensity exercise programme improved muscle strength, functional capacity and health-related quality of life in our elderly patients on HD. 2) Our results highlight the benefits from exercise in HD patients even in this elderly population. 3) In elderly patients on HD, it is worth considering an adapted low intensity intradialytic exercise programme as a part of a comprehensive care.
authors: Departamento de Medicina, Universitat Autónoma de Barcelona (UAB), Terrassa, Barcelona, España; Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España. Electronic address: vesteve@cst.cat.
authors: Vicent
authors: V
authors: Esteve Simo
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Anna
authors: A
authors: Junqué Jiménez
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Fátima
authors: F
authors: Moreno Guzmán
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: José
authors: J
authors: Carneiro Oliveira
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Miquel
authors: M
authors: Fulquet Nicolas
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Mónica
authors: M
authors: Pou Potau
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Anna
authors: A
authors: Saurina Sole
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Verónica
authors: V
authors: Duarte Gallego
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Irati
authors: I
authors: Tapia Gonzalez
authors: Servei de Nefrologia, Hospital de Terrassa, Consorci Sanitari Terrassa, Terrassa, Barcelona, España.
authors: Manel
authors: M
authors: Ramirez de Arellano
mesh_terms: D000369:Aged, 80 and over; D003191:Comprehensive Health Care; D003863:Depression; D005081:Exercise Therapy; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D053580:Muscle Strength; D062072:Patient Acuity; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Anciano; Ejercicio; Elderly; Exercise; Haemodialysis; Hemodiálisis