Effects Of Resistance Training On Physical Function And Quality Of Life Among Patients On Hemodialysis

Background:Skeletal muscle wasting is common in patients who receive maintenance hemodialysis treatment. This loss of muscle quantity and quality is associated with physical function deficits and reduced quality of life. Exercise training is one of the important elements in the management of muscle wasting. However, many frail older dialysis patients may not be able to perform moderate-to-high-intensity resistance training in previous studies. Thus, it is necessary to investigate the effect of low-to-moderate-intensity resistance training which makes more patients to participate in the course.Objective:To investigate the effect of low-to-moderate-intensity resistance training on muscle strength, physical function and quality of life among patients on hemodialysis.Methods:A quasi-experimental study was used in this study. By convenient sampling,88maintenance hemodialysis patients with muscle strength above grade3+(MRC Scale for Muscle Strength)were recruited from hemopurification centers of the General Hospital of Chinese People’s Liberation Army and Peking Union Medical College Hospital. The patients were assigned evenly into the exercise group (N=44) and the control group (N=44). The exercise group received low-to-moderate-intensity resistance training for about30minutes during per session,2sessions a week, for12weeks, while the control group received usual care. The resistance training consisted of upper and lower body exercises using elastic bands and sandbags. Outcome measures evaluated were:body circumference measures, muscle strength, physical function and quality of life.Results:73participants finished the whole data collecting process, and36of them were in the exercise group, the other were in the control group.(1) Intragroup analysis showed a statistically significant improvement in resistance group in arm circumference, flexed arm circumference, maximum forearm circumference, minimum forearm circumference, left and right thigh circumference, left calf circumference, left and right minimum calf circumference, and the rate of grade5of muscle strength of ectopectoralis, brachialis, brachioradilis, biceps brachii, triceps, left and right quadriceps, left musculi hippicus, and self-reported physical function and STS10.(2) Intergroup analysis showed a statistically significant improvement in maximum and minimum forearm circumference, left and right calf circumference, rate of grade5of muscle strength of ectopectoralis and biceps brachii, and the predicted-normal-value-reaching rate of STS10in the resistance group relative to the control group.(3) There were no statistically significant differences in quality of life except the dimension of physical function.(4)91.7%of the participants were satisfied with the low-to-moderate-intensity resistance training.Conclusions:The effect of low-to-moderate-intensity resistance training can significantly increase muscle strength and improve physical function in stable hemodialysis patients. However, it did not significantly improve quality of life except the physical function dimension. Most of participants were satisfied with the intervention given by elastic bands and sandbags. Future trials required to more objective and reliable measurement to investigate muscle strength in this cohout. The effect on quality of life still needs to be improved by extending the time of excersise.