Aim: The aim of the present study was to evaluate the influence of cycle exercise during hemodialysis (HD) on patients’ physical proficiency, muscle strength, quality of life and selected laboratory parameters. Patients and Methods: In a group of 29 (15 female, 14 male) HD patients (age 64.2 ± 13.1 years), 3 months of cycle training during dialysis sessions was performed. The following data were analyzed: strength of lower extremities (six-minute walk test, isokinetic knee extension, flexion peak torque), nutrition parameters (albumin, BMI), inflammation intensity (CRP, IL-6), and quality of life (SF-36v2). Results: In the six-minute walk test, the increase in walk velocity was 4% (3.56 km/h before and 3.73 km/h after cycle training; p < 0.01). At angular velocity (AV) of 60°/s, extension peak torque in the knee joint rose by 7% and at AV of 300°/s by 4% (p = 0.04). Flexion peak torque at AV of 180°/s increased by 13% (p = 0.0005). The program does not influence nutrition or inflammation parameters. No complications directly related to exercise were observed. Conclusion: Cycle exercise during dialysis is safe even in older HD patients with multiple comorbidities. It results in a significant increase in general patient walking ability and in a gain in lower extremity muscle strength.

1.
Fitts SS, Guthrie MR, Blagg CR: Exercise coaching and rehabilitation counseling improve quality of life for predialysis and dialysis patients. Nephron 1999;82:115–121.
2.
Kettner-Melsheimer A, Weiss M, Huber W: Physical work capacity in chronic renal disease. Int J Artif Organs 1987;10:23–30.
3.
Kutner NG, Zhang R, McClellan WM: Patient-reported quality of life early in dialysis treatment: effects associated with usual exercise activity. Nephrol Nurs J 2000;27:357–367.
4.
Beusterien KM, Nissenson AR, Port FK, Kelly M, Steinwald B, Ware JE Jr: The effects of recombinant human erythropoietin on functional health and well-being in chronic dialysis patients. J Am Soc Nephrol 1996;7:763–773.
5.
Moore GE, Parsons DB, Stray-Gundersen J, Painter PL, Brinker KR, Mitchell JH: Uremic myopathy limits aerobic capacity in hemodialysis patients. Am J Kidney Dis 1993;22:277–287.
6.
O’Hare AM, Tawney K, Bacchetti P, Johansen KL: Decreased survival among sedentary patients undergoing dialysis: results from the dialysis morbidity and mortality study wave 2. Am J Kidney Dis 2003;41:447–454.
7.
Altintepe L, Levendoglu F, Okudan N, Guney I, Savas Cilli A, Ugurlu H, Tonbul Z, Gokbel H, Turk S: Physical disability, psychological status, and health-related quality of life in older hemodialysis patients and age-matched controls. Hemodial Int 2006;10:260–266.
8.
Johansen KL, Sakkas GK, Doyle J, Shubert T, Dudley RA: Exercise counseling practices among nephrologists caring for patients on dialysis. Am J Kidney Dis 2003;41:171–178.
9.
Demers C, McKelvie RS, Negassa A, Yusuf S, RESOLVD Pilot Study Investigators: Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure. Am Heart J 2001;142:698–703.
10.
Redelmeier DA, Bayoumi AM, Goldstein RS, Guyatt GH: Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients. Am J Respir Crit Care Med 1997;155:1278–1282.
11.
Fitts SS, Guthrie MR: Six-minute walk by people with chronic renal failure. Assessment of effort by perceived exertion. Am J Phys Med Rehabil 1995;74:54–58.
12.
Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B, Burris J, Brewer B, Nindl BC, Coughlin M, Welles R, Jones M: Resistance training improves strength and functional measures in patients with end-stage renal disease. Am J Kidney Dis 2002;40:355–364.
13.
Painter P, Carlson L, Carey S, Paul SM, Myll J: Physical functioning and health-related quality-of-life changes with exercise training in hemodialysis patients. Am J Kidney Dis 2000;35:482–492.
14.
Bohannon RW: Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants. Age Ageing 1997;26:15–19.
15.
Karapolat H, Eyigor S, Zoghi M, Nalbantgil S, Yagdi T, Durmaz B, Ozbaran M: Health related quality of life in patients awaiting heart transplantation. Tohoku J Exp Med 2008;214:17–25.
16.
Brooks D, Solway S, Weinacht K, Wang D, Thomas S: Comparison between an indoor and an outdoor 6-minute walk test among individuals with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2003;84:873–876.
17.
Cowen TD, Huang CT, Lebow J, DeVivo MJ, Hawkins LN: Functional outcomes after inpatient rehabilitation of patients with end-stage renal disease. Arch Phys Med Rehabil 1995;76:355–359.
18.
Miller BW, Cress CL, Johnson ME, Nichols DH, Schnitzler MA: Exercise during hemodialysis decreases the use of antihypertensive medications. Am J Kidney Dis 2002;39:828–833.
19.
Załuska A, Załuska WT, Bednarek-Skublewska A, Ksiazek A: Nutrition and hydration status improve with exercise training using stationary cycling during hemodialysis (HD) in patients with end-stage renal disease (ESRD). Ann Univ Mariae Curie Sklodowska Med 2002;57:342–346.
20.
Castaneda C, Gordon PL, Parker RC, Uhlin KL, Roubenoff R, Levey AS: Resistance training to reduce the malnutrition-inflammation complex syndrome of chronic kidney disease. Am J Kidney Dis 2004;43:607–616.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.