Haruna Oyanagi1, Naoto Usui2,3, Atsuhiro Tsubaki4, Shuji Ando5, Masakazu Saithoh6, Sho Kojima1,4, Akihito Inatsu7, Hideki Hisadome8, Shigeyuki Ota9, Akimi Uehata8. 1. Department of Rehabilitation, Kisen Hospital, 1-35-8 Higashikanamachi, Katsushika-ku, Tokyo, 125 - 0041, Japan. 2. Department of Rehabilitation, Kisen Hospital, 1-35-8 Higashikanamachi, Katsushika-ku, Tokyo, 125 - 0041, Japan. chokujin.70@gmail.com. 3. Department of Nephrology, Graduate School of Medicine, Juntendo University, Tokyo, Japan. chokujin.70@gmail.com. 4. Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan. 5. Department of Information and Computer Technology, Tokyo University of Science, Tokyo, Japan. 6. Department of Physical Therapy, Faculty of Health Science, Juntendo University, Tokyo, Japan. 7. Division of Nephrology, Kisen Hospital, Tokyo, Japan. 8. Division of Cardiology, Kisen Hospital, Tokyo, Japan. 9. Division of Nephrology, Kisen Clinic, Tokyo, Japan.
Abstract
PURPOSE: Exercise prescription based on a population-specific physiological response can help ensure safe and effective physical interventions. However, as a facile approach for exercise prescription in hemodialysis population that is based on their exercise capacity has not yet been established, the aim of our study was to develop a unique prediction formula for peak heart rate (HR) that can be used in this population. METHODS: This cross-sectional study measured physical function and HR at peak exercise and anaerobic threshold (AT) during cardiopulmonary exercise tests in 126 individuals. Participants were randomly assigned to the development group (n = 78), whose data were used to calculate the prediction equation, or the validation group (n = 48). RESULTS: The HR reserve in this population was significantly lower (0.44 ± 0.20%) and there was a large discrepancy between conventional age-predicted maximal HR and measured peak-HR values (R = 0.36). The average of the ratio between HR at AT point and peak HR was 85% (95% CI, 83.5%-86.4%). The peak-HR prediction equation was based on resting HR, presence of diabetes, physical dysfunction (gait speed < 1.0 m/s), and hypoalbuminemia (< 3.5 g/dL). It showed high prediction accuracy (R2 [95%CI] = 0.71 [0.70-0.71]) with similar correlation coefficients between the development and validation groups (R = 0.82). CONCLUSION: Aerobic exercise based on estimated peak HR < 85% obtained from the equation in this study may enable safe and effective physical intervention in this population.
PURPOSE: Exercise prescription based on a population-specific physiological response can help ensure safe and effective physical interventions. However, as a facile approach for exercise prescription in hemodialysis population that is based on their exercise capacity has not yet been established, the aim of our study was to develop a unique prediction formula for peak heart rate (HR) that can be used in this population. METHODS: This cross-sectional study measured physical function and HR at peak exercise and anaerobic threshold (AT) during cardiopulmonary exercise tests in 126 individuals. Participants were randomly assigned to the development group (n = 78), whose data were used to calculate the prediction equation, or the validation group (n = 48). RESULTS: The HR reserve in this population was significantly lower (0.44 ± 0.20%) and there was a large discrepancy between conventional age-predicted maximal HR and measured peak-HR values (R = 0.36). The average of the ratio between HR at AT point and peak HR was 85% (95% CI, 83.5%-86.4%). The peak-HR prediction equation was based on resting HR, presence of diabetes, physical dysfunction (gait speed < 1.0 m/s), and hypoalbuminemia (< 3.5 g/dL). It showed high prediction accuracy (R2 [95%CI] = 0.71 [0.70-0.71]) with similar correlation coefficients between the development and validation groups (R = 0.82). CONCLUSION: Aerobic exercise based on estimated peak HR < 85% obtained from the equation in this study may enable safe and effective physical intervention in this population.
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