Long-term pulse wave velocity outcomes with aerobic and resistance training in kidney transplant recipients - A pilot randomised controlled trial.
BACKGROUND
This pilot study examined long-term pulse wave velocity (PWV) and peak oxygen uptake (VO2peak) outcomes following a 12-week moderate-intensity aerobic or resistance training programme in kidney transplant recipients.


METHODS
Single-blind, bi-centre randomised controlled parallel trial. 42 out of 60 participants completed a 9-month follow-up assessment (Aerobic training = 12, Resistance training = 10 and usual care = 20). Participants completed 12 weeks of twice-weekly supervised aerobic or resistance training. Following the 12-week exercise intervention, participants were transitioned to self-managed community exercise activity using motivational interviewing techniques. Usual care participants received usual encouragement for physical activity during routine clinical appointments in the transplant clinic. PWV, VO2peak, blood pressure and body weight were assessed at 12 weeks and 12 months, and compared to baseline.


RESULTS
ANCOVA analysis, covarying for baseline values, age, and length of time on dialysis pre-transplantation, revealed a significant mean between-group difference in PWV of -1.30 m/sec (95%CI -2.44 to -0.17, p = 0.03) between resistance training and usual care groups. When comparing the aerobic training and usual care groups at 9-month follow-up, there was a mean difference of -1.05 m/sec (95%CI -2.11 to 0.017, p = 0.05). A significant mean between-group difference in relative VO2peak values of 2.2 ml/kg/min (95% CI 0.37 to 4.03, p = 0.02) when comparing aerobic training with usual care was revealed. There was no significant between group differences in body weight or blood pressure. There were no significant adverse effects associated with the interventions.


CONCLUSIONS
Significant between-group differences in 9-month follow-up PWV existed when comparing resistance exercise intervention with usual care. A long-term between-group difference in VO2peak was only evident when comparing aerobic intervention with usual care. This pilot study, with a small sample size, did not aim to elucidate mechanistic mediators related to the exercise interventions. It is however suggested that a motivational interviewing approach, combined with appropriate transition to community training programmes, could maintain the improvements gained from the 12-week exercise interventions and further research in this area is therefore warranted.


BACKGROUND
study number: ISRCTN43892586.
Physiotherapy Department, King's College Hospital, London, United Kingdom.|Department of Renal Medicine, King's College Hospital, London, United Kingdom.|Renal Sciences, King's College London, London, United Kingdom.
Ellen M
http://orcid.org/0000-0002-6961-6108
EM
O'Connor
School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom.
Pelagia
P
Koufaki
School of Health Sciences, Queen Margaret University, Edinburgh, United Kingdom.
Thomas H
TH
Mercer
Physiotherapy Department, King's College Hospital, London, United Kingdom.
Herolin
H
Lindup
Department of Renal Medicine, Guys and St Thomas' Hospital, London, United Kingdom.
Eilish
E
Nugent
Department of Renal Medicine, Guys and St Thomas' Hospital, London, United Kingdom.
David
D
Goldsmith
Department of Renal Medicine, King's College Hospital, London, United Kingdom.|Renal Sciences, King's College London, London, United Kingdom.
Iain C
IC
Macdougall
Physiotherapy Department, King's College Hospital, London, United Kingdom.|Department of Renal Medicine, King's College Hospital, London, United Kingdom.|Renal Sciences, King's College London, London, United Kingdom.
Sharlene A
SA
Greenwood
D000328:Adult; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D055070:Resistance Training; D016037:Single-Blind Method