Effects Of Aerobic Exercise On Mineral Metabolism,Sleep Quality And Fatigue In Maintenance Hemodialysis Patient

Objective To study the effect of 12 week aerobic exercise intervention on mineral metabolism,sleep quality and fatigue in maintenance hemodialysis patients.Methods 50 MHD patients in Chaohu Hospital Affiliated to Anhui Medical University were selected and divided into exercise group(25 cases)and control group(25 cases).The control group only received MHD treatment,while the exercise group received aerobic exercise on the basis of MHD for 12 weeks.Aerobic exercise was performed on a treadmill three times a week for 30 to 40 minutes for 12 weeks.The bicycle training machine is fixed at the end of the dialysis bed.After 10 minutes of dialysis,the patients enter a stable state.First,they warm up for about 5 minutes in the passive exercise mode,then they do aerobic exercise for about 30 minutes in the active exercise mode,and finally they do relaxation exercise for about 5 minutes in the passive exercise mode.The exercise intensity was evaluated by Borg exercise consciousness scale,and the intensity was maintained at 11-12 points.The subjective evaluation was based on the patient’s slight fatigue and slight sweating,but no palpitation and asthma.The resistance was gradually increased,and maintained to the end after reaching the individual tolerable low and medium intensity.If the following conditions occur during the exercise,stop the exercise immediately: chest pain,chest tightness,sweating,dizziness,nausea,dyspnea,convulsions,etc.After the end of the study,the general clinical data,laboratory indexes,sleep quality score and fatigue score before and after exercise were collected and analyzed by spss22.0 softwareResults(1)48 patients completed the study.In the exercise group,2 patients had interrupted aerobic exercise,1 had been transferred to other hospitals for dialysis,and 1 patients had internal fistula and had been replaced by femoral vein catheterization.There was no significant difference in gender,age,dialysis age and etiology between the two groups(P > 0.05).(2)After 12 weeks,compared with the control group,the high sensitivity C-reactive protein(hs CRP)in the exercise group decreased after 12 weeks(P < 0.05);The blood phosphorus of exercise group decreased after 12 weeks(P < 0.05);However,after 12 weeks,there were no significant differences in hemoglobin,albumin,calcium,parathyroid hormone(PTH)and 25 hydroxyvitamin D(25(OH)d)between the exercise group and the control group or within the group(P > 0.05).(3)After 12 weeks,the Pittsburgh sleep quality index(PSQI)score of the exercise group was lower than that of the control group(P < 0.05);Compared within the group,the PSQI score of the exercise group decreased after 12 weeks(P < 0.05).(4)After 12 weeks,the fatigue Scale-14(fs-14)score of the exercise group was lower than that of the control group(P < 0.05);The fs-14 score of the exercise group decreased after 12 weeks(P < 0.05)Conclusions Aerobic exercise during hemodialysis can improve hs-CRP,blood phosphorus,sleep quality and fatigue of maintenance hemodialysis patients,but it has no clear effect on hemoglobin,albumin,blood calcium,PTH and 25(OH)D.