Table 2.
Intradialytic aerobic exercise and quality of life studies
| References and country | Sample | Intervention | Outcomes | |||
|---|---|---|---|---|---|---|
| Design | Exercise prescription | Variables + Groups | % Change (Cohen’s d) | p value | ||
|
Wu et al. [25] China |
I (n = 32); C (n = 33) | RCT: | I: [QOL-SF36] | + 37.7% | < 0.05a,b | |
| Age (yrs ± SD) | 3 months; 3 times/week | I: 5 min warm up + 10–15 min of cycling Intensity: Borg scale set between 12–16¶ | C: [QOL-SF36] | + 2.8% | NSa | |
| I (45/37–48); C: (44/41–50) | 20 min/session | C: 10–15 min simple stretching exercises | ||||
| Gender: | Setting: 1 HD unit | |||||
| I: 84.4% M; C: 84.8% M | ||||||
|
De Lima et al. [1] Brazil |
I (n = 10); C (n = 11) | RCT: | I: cycling | I: [KDQOL-SF 1.3—physical functioning] | NR | < 0.05b |
| Age (yrs ± SD) | 2 months; 3 times/week | Intensity: Borg scale set between 10–12¶ | I: [KDQOL-SF 1.3—pain] | NR | < 0.05b | |
| I (43.1 ± 13.3); C (43.5 ± 11.1) | 20 min/session | C: Received routine care | I: [KDQOL-SF 1.3—symptoms] | NR | < 0.04b | |
| Gender: | Setting: 1 HD unit | I: [KDQOL-SF 1.3—sleeping] | NR | < 0.006b | ||
| I: 50% M; C: 54.5% M | I: [KDQOL-SF 1.3—sexual function] | NR | < 0.01b | |||
| I: [KDQOL-SF 1.3—energy/fatigue] | NR | < 0.02b | ||||
| C: [KDQOL-SF 1.3] | NR | < 0.05b | ||||
|
Giannaki et al. [26] Greece |
I (n = 15); C (n = 7) | RCT: | I: cycling | I: [QOL-SF36—MCS] | + 15.2% (0.26) | NSa, NSb |
| Age (yrs ± SD) | 6 months; 3 times/week | Intensity: 60–65% of patient’s maximal exercise capacity | C: [QOL-SF36—MCS] | − 4.5% | NSa | |
| I (56.4 ± 12.5); C (56.8 ± 16.5) | 45–60 min/session | C: Received routine care + placebo pills | I: [QOL-SF36—PCS] | + 17.7% (0.27) | 0.003a, NSb | |
| Gender: | Setting: 1 HD unit | C: [QOL-SF36—PCS] | + 9.4% | NSa | ||
| I: 73.3% M; C: 71.4% M | ||||||
|
Dobsak et al. [27] Czech Republic |
I (n = 11); C (n = 10) | RCT: | I: 5 min warm up + 20–40 min cycling + 5 min cool down | I: [QOL-SF36—MCS] | + 8.5% (0.03) | 0.001a, NRb |
| Age (yrs ± SD) | 4.6 months; 3 times/week | Intensity: 30–60% of patient’s peak workload | C: [QOL-SF36—MCS] | + 1.7% | NSa | |
| I (58.2 ± 7.2); C (60.1 ± 8.1) | 30–50 min/session | C: Received routine care | I: [QOL-SF36—PCS] | + 11.1% (0.19) | 0.006a, NRb | |
| Gender: | Setting: 1 HD unit | C: [QOL-SF36—PCS] | − 1.5% | NSa | ||
| I: 36.3% M; C: 66.6% M | ||||||
|
Koh et al. [28] Australia |
I (n = 15); C (n = 16) | RCT: | I: 2 weeks of conditioning: 15 min cycling/session | I: [QOL-SF36—MCS] | − 3.3% (0.26) | NSa, NSb |
| Age (yrs ± SD) | 5 months; 3 times/week | 9 weeks: 30 min cycling/session | C: [QOL-SF36—MCS] | − 3.0% | NSa | |
| I (52.3 ± 10.9); C (51.3 ± 14.4) | 15 to 45 min/session | 9 weeks: 45 min cycling/session | I: [QOL-SF36—PCS] | − 11.3% (0.35) | NSa, NSb | |
| Gender: | Setting: 3 HD units | Intensity: Borg scale set between 12–13¶ | C: [QOL-SF36—PCS] | No Δ | NSa | |
| I: 66.6% M; C: 50% | C: Received routine care | |||||
|
Sakkas et al. [29] Greece |
I (n = 7); C (n = 7) | 2 Groups intervention: | I: 5 min warm up + 45 min cycling + 5 min cool down | I: [QOL-SF36—MCS] | + 26.6% (0.99) | NSa, NRb |
| Age (yrs ± SD) | 3.7 months; 3 times/week | Intensity: 65–75% of patient’s maximum power capacity | C: [QOL-SF36—MCS] | − 10.1 | NSa | |
| I (48 ± 14); C (70 ± 11) | 55 min/session | C: Received routine care | I: [QOL-SF36—PCS] | + 23.8% (1.78) | 0.01a, NRb | |
| Gender: | Setting: 1 HD unit | C: [QOL-SF36—PCS] | + 14.5% | NSa | ||
| I: 71.4% M; C: 71.4% M | ||||||
|
Parsons et al. [30] Canada |
I (n = 6); C (n = 7) | RCT: | I: three 15 min exercise bouts of cycling | I: [QOL-SF36—physical function] | + 1.1% | NSa, NRb |
| Age (yrs ± SD) | 2 months; 3 times/week | Intensity: 40–50% of maximal work capacity | C: [QOL-SF36—physical function] | − 4.2% | NSa | |
| I (60 ± 17); C (49 ± 25) | 45 min/session | C: Received routine care | I: [QOL-SF36—role emotional] | − 7.7% | NSa, NRb | |
| Gender: | Setting: 1 HD unit | C: [QOL-SF36—role emotional] | + 17.6% | NSa | ||
| I: 50% M; C: 57.1% M | I: [QOL-SF36—bodily pain] | + 2.1% | NSa, NRb | |||
| C: [QOL-SF36—bodily pain] | + 10.1% | NSa | ||||
| I: [QOL-SF36—general health] | − 13.7% | NSa, NRb | ||||
| C: [QOL-SF36—general health] | − 13.4% | NSa | ||||
| I: [QOL-SF36—vitality] | − 6.9% | NSa, NRb | ||||
| C: [QOL-SF36—vitality] | + 1.2% | NSa | ||||
| I: [QOL-SF36—social function] | − 2.6% | NSa, NRb | ||||
| C: [QOL-SF36—social function] | + 12.4% | NSa | ||||
| I: [QOL-SF36—role physical] | + 16.4% | NSa, NRb | ||||
| C: [QOL-SF36—role physical] | + 26.7% | NSa | ||||
| I: [QOL-SF36—mental health] | + 3.4% | NSa, NRb | ||||
| C: [QOL-SF36—mental health] | + 1.0% | NSa | ||||
|
Painter et al. [31] USA Painter et al. [31] USA¥ |
I (n = 166); C (n = 28) | 2 Groups intervention: | I: strengthening + stretching exercises at home for 2 months followed by intradialytic cycling for 2 months | I: [QOL-SF36—MCS] | + 4.7% (0.0) | NRa, NSb |
| Age (yrs ± SD) | 2 months; 30 min/session | C: [QOL-SF36—MCS] | − 0.1% | NRa | ||
| I (55.9 ± 15.15); C (52.8 ± 16.8) | Setting: 5 HD units | Intensity: based on the perceived exertion scale to fit their tolerable rate | I: [QOL-SF36 -PCS] | + 9.1% (0.64) | NRa, 0.001b | |
| Gender: | C: [QOL-SF36—PCS] | − 15.6% | NRa | |||
| I: 42.9% M; C: 34.6% M | C: Received routine care | |||||
|
Chigira et al. [32] Japan |
n = 7 | Single group Intervention: | 15 min of warm up and stretching + 20 min cycling + 1 min cool down | [WHO-QOL26] | + 4.1% | NS |
| Age (yrs ± SD) | 3 months; 2–3 times/week 40 min/session | Intensity: Borg scale set between 11 and 13¶ | ||||
| Gender: 71.4% M | Setting: 1 HD unit | |||||
|
Bae et al. [33] Korea |
n = 10 | Single group Intervention: | 5 min warm up + 30 min cycling + 2 min cool down | I: [QOL-SF36] | + 14.7% | NS |
| Age (yrs ± SD) | 3 months; 2–3 times/week | Intensity: at 35 rpm + Borg scale set between 11 and 13¶ | ||||
| 56.5 ± 4.4 | 30 min/session | |||||
| Gender: 40% M | Setting: 1 HD unit | |||||
|
Musavian et al. [14] Iran |
n = 16 | Single group Intervention: | (a) 8 weeks: control period | (d) [QOL-SF36] | + 20.8% | 0.007 |
| Age (yrs ± SD) | 4 non-consecutive months | (b) 8 weeks: 30 min of passive cycling | ||||
| 51.9 ± 1.57 | 3 times/week | (c) 8 weeks: washout | ||||
| Gender: 81.2% M | 30 min/session | (d) 8 weeks: 30 min of active cycling | ||||
| Setting: 1 HD unit | Intensity: not reported | |||||
|
Bohm et al. [34] Canada |
n = 20 | Single group Intervention: | Cycling intensity: Borg scale set between 12 and 14¶ | [QOL-SF36- PCS] | + 11.4%* | NS |
| Age (yrs ± SD) | 6 months; 3 times/week | [QOL-SF36- MCS] | − 2.0%* | NS | ||
| 52 ± 14.5 | 60 min/session | |||||
| Gender: 73% M | Setting: 4 HD units | |||||
|
Golebiowski et al. [35] Poland |
n = 21 | Single group Intervention: | Cycling intensity: physical load was individually adapted to exercise tolerance | [QOL- SF36v2] | Increase | NS |
| Age (yrs ± SD) | 3 months; 3 times/week | Sub group analysis of patients with the | ||||
| 64.2 ± 13.1 | 50 ± 19 min/session | lowest [physical function] initially: [physical functioning] | + 88.8% | 0.04 | ||
| Gender: 51.7% M | Setting: 1 HD unit | |||||
|
Besnier et al. [42] France |
n = 6 | Single group Intervention | Cycling at a speed of 60–70 turns per minute” | [QOL-SF36—PCS] | + 12.3% | NR |
| Age (yrs ± SD) | 3 months; 3 times/week | Intensity: Moderate intensity exercise was maintained when patient reaches the value of his first ventilator threshold | [QOL-SF36—MCS] | − 2.8% | NR | |
| 72.5 ± 7.8 | 30 min/session | Significance unreported | ||||
| Gender: 66.6% M | Setting: 1 HD unit | |||||
|
Reboredo et al. [13] Brazil |
n = 14 | Single group Intervention | Pre intervention conditioning: 12 weeks of stretching for 10 min of the lower limbs | [QOL-SF36—physical function] | + 17.1% | < 0.05 |
| Age (yrs ± SD) | 3 month; 3 times/wee | [QOL-SF36—social functioning] | + 15.1% | < 0.05 | ||
| 47.6 ± 12.8 | 30 min/session | Intervention: 15 min of stretching and warm up + 30 min of cycling + 15 min cool down and stretching | [QOL-SF36—mental health] | + 18.1% | < 0.05 | |
| Gender: 28.6% M | Setting: 1 HD unit | [QOL-SF36—role physical] | + 13.4% | NS | ||
| Intensity: Borg scale set between 11–13¶ | [QOL-SF36—pain] | + 22.2% | NS | |||
| [QOL-SF36—general health] | − 6.4% | NS | ||||
| [QOL-SF36—vitality] | + 4.1% | NS | ||||
| [QOL-SF36—role emotional] | + 18.0% | NS | ||||
|
McMurray et al. [36] Australia |
n = 19 | Single group Intervention: | Cycling Intensity: based on individual’s capacity to cope with the program | [QOL-SF12—MCS] | − 12.6% | NS |
| Age (yrs ± SD) | 3 months; 3 times/week | [QOL-SF12—PCS] | − 22.2% | NS | ||
| 67.6 ± 11.2 | 40 min/session | |||||
| Gender: 63.6% M | Setting: 1 HD unit | |||||
|
Parsons et al. [37] Canada |
n = 13 | Single group Intervention: | Cycling: two 30 min exercise bouts with a 30 min recovery period between bouts | [KDQOL] | NR | NS |
| Age (yrs ± SD) | 5 months; 3 times/week | [QOL-SF36] | NR | NS | ||
| 53.0 ± 18.0 | 60 min/session | Intensity: based on patient’s capacity | ||||
| Gender: 61.5% M | Setting: 2 HD units | |||||
Order of the studies: randomized controlled studies followed by single group studies, and in descending order of the publication year
p significance, Yrs years, SD standard deviation, M male, RCT randomized controlled trial, Min minutes, HD hemodialysis, I intervention, C control, QOL quality of life, NS non-significant, NR not reported, PCS physical component summary, MCS mental component summary, USA United States of America
¶Borg scale set between 12–14 is described a “somewhat hard” and is equivalent to a moderate intensity exercise; asignificance for within group comparison with baseline; bsignificance of intervention compared with control group; ¥ this study was a subgroup study so we only reported the results of the mother study; *measurement reported from a figure