The association between six month intra-dialytic resistance training and muscle strength or physical performance in patients with maintenance hemodialysis: a multicenter retrospective observational study

BackgroundReduced muscle strength and physical performance are prevalent in patients of maintenance hemodialysis (MHD), and deleterious changes in these parameters are associated with increased mortality.MethodsThis retrospective observational study included 306 patients, who received a 6-month resistance exercise program during hemodialysis, three times per week on an outpatient basis. The training protocol consisted of two sets of 10 repetitions of knee extension, hip abduction, and hip flexion, using an elastic band in a sitting or supine position. Primary outcome measures included muscle strength, measured by percent knee extension muscle power to dry body weight (pKEMP-dBW), and physical performance, measured by short physical performance battery (SPPB). The adjusted mean differences in these variables during the 6months were estimated using a multivariate linear regression model.ResultsThe mean age with standard deviation was 7011years. One hundred and sixty patients (52.3%) were men and the dry weight was 55.6 +/- 11.3kg. Sarcopenia, defined as SPPB 8, was present in 21.4% patients. Their hemodialysis adequacy was acceptable, with a Kt/V of 1.65 +/- 0.29, and their nutritional status was good, with a normalized protein catabolism rate of 0.89 +/- 0.18g/kg/day. During the 6months, both pKEMP-dBW and SPPB showed a slight but significant increase with an adjusted mean difference of 2.8 (95% confidence interval 1.3-4.3, p<0.001) and 0.6 (0.4-0.9, p<0.001), respectively.Conclusions p id=Par4 Six-month resistance training was associated with improved muscle strength and physical performance in patients with MHD.