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Seven months of aerobic intradialytic exercise training can prevent muscle loss in haemodialysis patients: an ultrasonography study

  • Nephrology - Original Paper
  • Published:
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Abstract

Purpose

This study aimed to evaluate the effects of 7-month intradialytic exercise training (IDE) on vastus lateralis (VL) muscle architecture, functional capacity and quality of life in stable haemodialysis (HD) patients.

Methods

44 HD patients were randomly assigned into an Exercise Group (EG = 21), which they received 7 months of IET, at 60% of pre-assessed maximum aerobic power, 3/week) or into a Control Group (CG = 23, no exercise). VL architecture was evaluated with ultrasonography, functional capacity was assessed using a series of functional tests (6 min walking test, 5 repetitions sit-to-stand, sit-to-stand 60 s, handgrip strength), and maximal aerobic power determined with a modified version of the Åstrand test. Quality of life and fatigue levels were evaluated using validated questionnaires.

Results

VL fascicle angle and length did not change significantly in both groups (P > 0.05). Muscle thickness decreased in CG (P = 0.02) while it was fully preserved in the EG. Functional capacity increased only in the EG (6 min walking test 15.79 ± 12.35%, P < 0.001; max aerobic power 26.36 ± 1.24%, P < 0.001; STS-60rep: 10.23 ± 1.60%, P < 0.000; hand grip strength: 5.14 ± 28.30%, P < 0.02).

Conclusion

Intradialytic aerobic exercise training, improves functional capacity and prevents thigh muscle mass loss in HD patients. It is evident that muscle ultrasonography could play a pivotal role in assessing muscle quality changes in haemodialysis patients. A higher level of training intensity or combination with resistance exercises may be required to further improve anabolism and influence muscle architecture in this patient population.

Clinical Trial Registry number

NCT03905551.

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Availability of data and materials

The datasets of the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank all hemodialysis patients who volunteered for the purposes of this study, as well as the staff at the hemodialysis unit of the General Hospital of Trikala, and Eftychios Patsides General Clinic, Larissa, Greece, for their expert advice and valuable help.

Funding

This study received funding from the European Union’s Horizon 2020 programme (Grant agreement No. 645710). Also supported by the European Union Horizon 2020 Research and Innovation Programme “H2020 MSCAS-RISE-Muscle Stress Relief” (Grant agreement No. 645648).

Author information

Authors and Affiliations

  1. Department of Physical Education and Sport Science, University of Thessaly, 42100, Trikala, Greece

    Argyro A. Krase, Chrisitna Karatzaferi & Giorgos K. Sakkas

  2. Sports Performance Laboratory, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece

    Gerasimos Terzis & Aggeliki N. Stasinaki

  3. Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus

    Christoforos D. Giannaki

  4. Department of Health Sciences, University of Leicester, Leicester, UK

    Thomas J. Wilkinson & Alice C. Smith

  5. Division of Nephrology, Department of Medicine, University of Thessaly, Larissa, Greece

    Constantinos Zorz & Ioannis Stefanidis

  6. School of Sports and Health Sciences, Cardiff Metropolitan University, Cardiff, UK

    Giorgos K. Sakkas

Authors
  1. Argyro A. Krase
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  2. Gerasimos Terzis
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  3. Christoforos D. Giannaki
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  4. Aggeliki N. Stasinaki
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  5. Thomas J. Wilkinson
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  6. Alice C. Smith
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  7. Constantinos Zorz
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  8. Chrisitna Karatzaferi
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  9. Ioannis Stefanidis
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  10. Giorgos K. Sakkas
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Contributions

AAK, GKS led to the substantial conception and design of the study. GKS coordinated the project. AAK, CDG and GKS, designed the field experiments and AAK and CZ contributed to the acquisition of the data. GT, ANS and AAK conducted the data analysis. AAK and CZ run the exercise training. CK and IS led the quality assessment. All authors contributed to data interpretation. GKS, and CDG, led the manuscript writing. AAK, GKS, contributed to writing the manuscript. All authors contributed to the revision, final formulation of the manuscript and to the final approval of the version to be published.

Corresponding author

Correspondence to Giorgos K. Sakkas.

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Conflict of interest

There are no financial or non-financial competing interests associated with this study.

Consent to participate

All patients gave their written informed consent prior to study participation.

Consent for publication

There are no individual person’s data in the manuscript.

Ethical approval

The study was approved by the Human Research and Ethics Committee of the University of Thessaly, and by the bioethics committee of the General Hospital of Trikala, Greece (Protocol No 921/05-11-2014).

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Krase, A.A., Terzis, G., Giannaki, C.D. et al. Seven months of aerobic intradialytic exercise training can prevent muscle loss in haemodialysis patients: an ultrasonography study. Int Urol Nephrol 54, 447–456 (2022). https://doi.org/10.1007/s11255-021-02931-6

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  • DOI: https://doi.org/10.1007/s11255-021-02931-6

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