Luca Pomidori1,2, Nicola Lamberti3, Anna Maria Malagoni4,5, Fabio Manfredini3, Enrico Pozzato4,6, Michele Felisatti4,6, Luigi Catizone7, Antonio Barillà7, Alessandro Zuccalà8, Giovanni Tripepi9, Francesca Mallamaci9,10, Carmine Zoccali10, Annalisa Cogo4,3. 1. Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy. pmdlcu@unife.it. 2. Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy. pmdlcu@unife.it. 3. Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences, University of Ferrara, Ferrara, Italy. 4. Biomedical Sport Studies Centre, University of Ferrara, Ferrara, Italy. 5. Unit of Translational Surgery, Hospital University of Ferrara, Ferrara, Italy. 6. Esercizio Vita ONLUS, Via Don Giovanni Calabria 13, 44124, Ferrara, Italy. 7. Nephrology Dialysis Unit, Hospital University of Ferrara, Ferrara, Italy. 8. Nephrology Dialysis Unit, Civil Hospital of Imola, Imola, Italy. 9. CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Reggio Calabria, Italy. 10. Nephrology and Renal Transplantation Division, Ospedali Riuniti, Reggio Calabria, Italy.
Abstract
AIM: Skeletal muscle atrophy and dysfunction with associated weakness may involve the respiratory muscles of dialysis patients. We evaluated the effect of moderate-intensity exercise on lung function and respiratory muscle strength. METHODS:Fifty-nine patients (25 F, aged 65 ± 13 years) from two centers participating in the multicenter randomized clinical trialEXerCise Introduction To Enhance Performance in Dialysis (EXCITE) were studied. Subjects were randomized into a prescribed exercise group (E), wherein subjects performed two 10-min walking sessions every second day at an intensity below the self-selected speed, or a control group (C) with usual care. Physical performance was assessed by the 6-min walk test (6MWT). Patient lung function and respiratory muscle strength were evaluated by spirometry and maximal inspiratory pressure (MIP), respectively. RESULTS:Forty-two patients (14 F) completed the study. At baseline, the groups did not differ in any parameters. In total, 7 patients (4 in E; 3 in C) showed an obstructive pattern. The pulmonary function parameters were significantly correlated with 6MWT but not with any biochemical measurements. Group E safely performed the exercise program. At follow-up, the spirometry parameters did not change in either group. A deterioration of MIP (-7 %; p = 0.008) was observed in group C, but not in group E (+3.3 %, p = ns). In E, an increase of 6MWT was also found (+12 vs. 0 % in C; p = 0.038). CONCLUSION: In dialysis patients, a minimal dose of structured exercise improved physical capacity and maintained a stable respiratory muscle function, in contrast to the control group where it worsened.
RCT Entities:
AIM: Skeletal muscle atrophy and dysfunction with associated weakness may involve the respiratory muscles of dialysis patients. We evaluated the effect of moderate-intensity exercise on lung function and respiratory muscle strength. METHODS: Fifty-nine patients (25 F, aged 65 ± 13 years) from two centers participating in the multicenter randomized clinical trial EXerCise Introduction To Enhance Performance in Dialysis (EXCITE) were studied. Subjects were randomized into a prescribed exercise group (E), wherein subjects performed two 10-min walking sessions every second day at an intensity below the self-selected speed, or a control group (C) with usual care. Physical performance was assessed by the 6-min walk test (6MWT). Patient lung function and respiratory muscle strength were evaluated by spirometry and maximal inspiratory pressure (MIP), respectively. RESULTS: Forty-two patients (14 F) completed the study. At baseline, the groups did not differ in any parameters. In total, 7 patients (4 in E; 3 in C) showed an obstructive pattern. The pulmonary function parameters were significantly correlated with 6MWT but not with any biochemical measurements. Group E safely performed the exercise program. At follow-up, the spirometry parameters did not change in either group. A deterioration of MIP (-7 %; p = 0.008) was observed in group C, but not in group E (+3.3 %, p = ns). In E, an increase of 6MWT was also found (+12 vs. 0 % in C; p = 0.038). CONCLUSION: In dialysis patients, a minimal dose of structured exercise improved physical capacity and maintained a stable respiratory muscle function, in contrast to the control group where it worsened.
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