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Effect of exercise training on functional capacity, muscle strength, exercise capacity, dialysis efficacy and quality of life in children and adolescents with chronic kidney disease: a systematic review and meta-analysis

  • Nephrology - Review
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Abstract

Purpose

To synthesize the effect of exercise training on functional capacity, muscle strength, exercise capacity, dialysis efficacy, and quality of life (QOL) in children and adolescents with CKD.

Methods

PubMed/Medline, Scopus, PEDro, Web of Science, CINAHL, Cochrane, and Embase were searched from inception to September 30, 2023. Randomized control trials (RCTs) and clinical trials that assessed the effect of exercise training programs on functional capacity, muscle strength, exercise capacity, dialysis efficacy, and QOL in children and adolescents with CKD were included. Random effect model and meta-regression were used for the meta-analysis.

Results

Four clinical trials and three RCTs were included. The results showed that exercise training improves strength, but meta-analysis did not show a significant effect of exercise on functional capacity (WMD: 1.02; 95% CI: − 0.14 to 2.18; p = 0.083) and QOL (WMD: 8.00; 95% CI: − 3.90 to 19.91; p = 0.187). Subgroup analysis revealed that more than 25 sessions and 45 min per session of intervention, a PEDro score of more than 5, and being younger than 12 years of age had a large effect on functional capacity and QOL results. Due to the limited number of studies that reported the effect of exercise on dialysis efficacy and exercise capacity, the findings were inconclusive.

Conclusion

Exercise training could benefit children and adolescents with CKD by increasing their strength. Longer exercise interventions may be beneficial for improving functional capacity and QOL. Future well-designed RCTs should overcome the existing limitations using adequate sample sizes and longer exercise durations.

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Data availability

The data presented in this study are available on reasonable request from the corresponding author.

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Author information

Authors and Affiliations

  1. Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

    Mehrnaz Kajbafvala, Shabnam ShahAli & Ismail Ebrahimi Takamjani

  2. Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran

    Zinat Ashnagar

  3. Department of Pediatric Nephrology, Ali-Asghar Children’s Hospital, Iran University of Medical Sciences, Tehran, Iran

    Rozita Hosseini

  4. Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran

    Saeed Shahabi

  5. Department of Physiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Anahita Hejazi

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Contributions

MK, concept development, writing the manuscript, editing, data collection/processing, and revising the manuscript for important intellectual content. SSA, writing the manuscript, editing, data collection/processing, interpreting the relevant literature, interpretation of data, and revising the manuscript for important intellectual content. IET, writing manuscript, editing. ZA, data collection and editing. RHS, data collection and editing. SS, literature search and editing. AH data analysis and interpretation of data.

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Correspondence to Shabnam ShahAli.

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Kajbafvala, M., ShahAli, S., Ebrahimi Takamjani, I. et al. Effect of exercise training on functional capacity, muscle strength, exercise capacity, dialysis efficacy and quality of life in children and adolescents with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol (2023). https://doi.org/10.1007/s11255-023-03887-5

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