Table 2.
Response to exercise training in HD or PD patients.
| Column | Reference, Study Design | No. of Patients | Type of Participants | Methods of Intervention | Duration | Significant Results |
|---|---|---|---|---|---|---|
| 1 | Sheshadri et al., 2020 [23,24], randomized controlled trial | Rx-30 Control-30 |
Undergoing HD or PD; older than 18 years | Rx: Used pedometers with counseling to increase their daily steps by 10% each week. Control: usual care |
3 months intervention and 3 months post-intervention follow-up | Rx vs. control at 3 months: ↑ daily steps, ↑ heart rate variability; no change in total body muscle mass, BMI, fat mass, short physical performance battery score, and endothelial function Rx vs. control at 6 months: ↑ total body muscle mass; ↓ BMI, ↓ fat mass; no change in daily steps, short physical performance battery score, endothelial function, or heart rate variability |
| 2 | Cooke et al., 2018 [25], open-label randomized controlled trial | Rx-10 Control-10 |
HD; mean age 55 ± SD 16 years, mean BMI 26.4 ± SD 5.2 kg/m2 | Rx: pedaling exercise during HD Control: usual care |
4 months | Rx vs. control: ↑ waist:hip ratio; ↓ heart rate-corrected augmentation index, ↓ carotid femoral pulse wave velocity, ↓ heart rate; no change in handgrip strength, gait speed, BMI, albumin, peripheral, and central blood pressure |
| 3 | Manfredini et al., 2017 [26], randomized controlled trial |
Rx-151 Control-145 |
HD or CAPD | Rx: low-intensity home-based personalized walking exercise Control: usual care |
6 months | Rx vs. control: ↑ 6MWT; ↓ STS; no change in albumin, heart rate, and blood pressure |
| 4 | Thompson et al., 2016 [27], randomized controlled trial | Rx1-8 Rx2-7 Rx3-8 Control-8 |
HD; older than 18 years | Rx1: aerobic exercise (cycling) during HD Rx2: resistance exercise during HD Rx3: combined exercise (aerobic + resistance) during HD Control: routine stretching during HD |
3 months | Three Rx groups vs. control: No change in 6MWT, STS, and muscle strength (one repetition maximum) |
| 5 | Bennett et al., 2016 [28], prospective stepped intradialytic resistance training randomized controlled trial |
Rx1-80 Rx2-80 Rx3-68 |
HD; older than 18 years | Rx1, Rx2, Rx3: resistance exercise during HD. The time of commencement of the resistance training program in each HD unit was determined randomly. | Rx1: 9 months Rx2: 6 months Rx3: 3 months |
With intradialytic resistance training: ↑ STS; ↓ 8-ft timed up-and-go |
| 6 | Olvera-Soto et al., 2016 [9], randomized controlled trial | Rx-30 Control-31 |
HD; older than 18 years, (83% with some grade of malnutrition) | Rx: resistance exercise during HD Control: usual care |
3 months | Significant changes within each group: Rx: ↑ percentage body fat, ↑ arm muscle circumference, ↑ arm muscle area, ↑ handgrip strength Control: ↓ handgrip strength Rx vs. control: ↑ handgrip strength; no change in dietary protein or energy intake, percentage body fat, arm muscle circumference, and arm muscle area |
| 7 | Lewis et al., 2015 [29], randomized controlled trial | Rx1-15 Rx2-13 Rx3-17 Rx4-14 Control-22 |
HD; mean age 42.1 ± SD 1.5 years; healthy matched controls mean age 40.9 ± SD 2.6 years | Rx1: HD, no training Rx2: HD, endurance training Rx3: HD, strength training RX4: HD, a combination of endurance and strength training Control: normal sedentary people with no exercise training |
22 weeks | Significant changes within each group: Rx2: ↑ number of capillaries in type I and IIA fibers of vastus lateralis, ↑ capillary density of vastus lateralis, ↑ capillary-to-fiber ratio Rx3: No change in the number of capillaries in any type of fibers of vastus lateralis, capillary density of vastus lateralis, and capillary-to-fiber ratio. Rx4: ↓ thickness of type I and IIA fiber CSA in vastus lateralis; ↑ capillary number in type I, IIA, and IIX fibers of vastus lateralis; ↑ capillary density of vastus lateralis, ↑ capillary-to-fiber ratio With any type of training (Rx2, Rx3, and Rx4) vs. no training (Rx1): No change in the proportion of type I, IIA, and IIX fibers in vastus lateralis muscle and succinate dehydrogenase activity in type I, IIA, and IIX fibers in vastus lateralis |
| 8 | Matsufuji et al., 2015 [30], prospective randomized parallel controlled trial |
Rx-12 Control-15 |
HD; age range 61–79 years | Rx: chair stand exercise before HD Control: stretching exercise before HD |
3 months | Rx vs. control: ↑ functional independence measure; no change in thigh circumference, knee extensor strength, 6MWT, and albumin |
| 9 | Bohm et al., 2014 [10], prospective randomized trial | Rx1-30 Rx2-30 |
HD; older than 18 years | Rx1: ergometer cycling during HD Rx2: pedometer home-based walking |
6 months | Significant changes within each group: Rx1: ↑ STS, ↑ SR; no change in VO2 peak, 6MWT, and PAL Rx2: ↑ STS, ↑ SR; no change in VO2 peak, 6MWT, and PAL Rx1 vs. Rx2: No change in VO2 peak, 6MWT, STS, SR, and PAL |
| 10 | Kirkman et al., 2014 [31], randomized controlled trial | Rx1-12 Rx2-5 Control1: 11 Control2: 4 |
HD; older than 18 years; normal sedentary individuals | Rx1: progressive resistance training during HD Rx2: progressive resistance training in normal individuals Control1: low-intensity lower body stretching during HD Control2: low-intensity lower body stretching in normal individuals |
3 months | Rx1 vs. control1: ↑ thigh muscle volume, ↑ knee extensor strength; no change in STS, 6MWT, and 8-ft get-up-and-go test Rx2 vs. control2: ↑ STS, ↑ 6MWT; no change in thigh muscle volume, knee extensor strength, and 8-ft get-up-and-go test Rx1 vs Rx2: ↑ STS (greater increase in normal group); no change in thigh muscle volume, knee extensor strength, 6MWT, and 8-ft get-up-and-go test |
| 11 | De lima et al., 2013 [32], randomized controlled trial | Rx1-11 Rx2-10 Control-11 |
HD; age range 18–75 years | Rx1: strength training during HD Rx2: aerobic training during HD Control: usual care |
2 months | Two Rx groups vs. control: ↑ respiratory muscular strength, ↑ number of steps achieved |
| 12 | Song et al., 2012 [33], randomized controlled trial | Rx-20 Control-20 |
HD; older than 18 years | Rx: resistance training during HD Control: usual care |
3 months | Rx vs. control: ↑ skeletal muscle mass, ↑ leg muscle strength; ↓ body fat rate; no change in visceral far area, waist circumference, arm muscle circumference, and handgrip strength |
| 13 | Chen et al., 2010 [34], randomized controlled trial | Rx-25 Control-25 |
HD; older than 30 years; serum albumin < 4.2 g/dL | Rx: low-intensity strength training during HD Control: stretching exercise |
6 months (48 exercise sessions) | Rx vs. control: ↑ lean whole-body mass, ↑ leg lean mass, ↑ knee extensor strength, ↑ short physical performance battery score, ↑ self-reported physical function, ↑ leisure-time physical activity; ↓ whole-body fat mass |
| 14 | Kopple et al., 2007 [35], randomized controlled trial | Rx1-10 Rx2-15 Rx3-12 Control1-14 non-exercising HD Control2-20 normal people |
HD; age range 25–65 years; healthy matched controls | Rx1: endurance training during HD Rx2: strength training before HD Rx3: endurance + strength training before and during HD Control1: usual care HD Control2: non-exercising normal |
22 weeks | Significant changes within each group: Rx1: ↑ muscle mRNA in IGF-1 and IGFBP-2 Rx2: ↑ muscle mRNA in IGF-IEa and IGF-1 Rx3: In muscle, ↑ IGF-IEa mRNA, ↑ IGF-IEc mRNA, ↑ IGF-II mRNA Significant changes in Rx1, Rx2, and Rx3 combined: ↑ vastus lateralis muscle mRNA in IGF-IEa, IGF-IEc, IGF-IR, IGF-II, IGFBP-2, and IGFBP-3, ↑ muscle IGF-1, ↑ anthropometry derived fat-free mass; ↓ muscle mRNA of myostatin, ↓ skinfold thickness, ↓ anthropometry-derived percentage body fat and total body fat; no change in dietary protein or energy intake, c-reactive protein, tumor necrosis factor alpha, and IL-6 |
| 15 | Cheema et al., 2007 [36], randomized controlled trial | Rx-24 Control-25 |
HD; older than 18 years | Rx: high-intensity resistance training during HD Control: usual care |
3 months | Rx vs. control: ↓ thigh muscle lipid infiltration, ↓ c-reactive protein; ↑ total strength, ↑ mid-arm circumference, ↑ mid-thigh circumference, ↑ body weight, ↑ BMI; no change in dietary energy or protein intake, total or subcutaneous fat of the mid-thigh, muscle CSA, 6MWT, and habitual physical activity |
| 16 | Storer et al., 2005 [37] † | Rx-12 HD Control1-12 non-exercising MHD Control2-12 normal people |
HD; Normal matched controls | Rx: stationary-cycle endurance training during HD Control1: non-exercising HD patients Control2: non-exercising normal |
9 weeks | Significant changes within each group: Rx: ↑ quadriceps strength, ↑ leg-press fatigability, ↑ stair-climb time, ↑ 10 m walk, ↑ timed up-and-go, ↑ VO2 peak, ↑ endurance time Non-exercise HD and normal subjects: no changes. |
| 17 | Vilsteren et al., 2005 [38], randomized controlled trial | Rx-53 Control-43 |
HD; older than 18 years | Rx: strength training (before HD) plus cycling (during HD) Control: usual care |
3 months | Rx vs. control: ↑ reaction time, ↑ lower extremity muscle strength; no change in VO2 peak |
↑ Increase; ↓ Decrease; Rx: Treatment group; HD: hemodialysis; PD: peritoneal dialysis; SD: standard deviation; CAPD: continuous ambulatory peritoneal dialysis; BMI: body mass index; CSA: cross sectional area; IL-6: Interleukin-6; 6MWT: six-minute walk test; STS: sit-to-stand; SR test: sit-and-reach test (measurement of flexibility); PAL: physical activity level; VO2 peak: peak oxygen consumption; IGF: insulin-like growth factor; IGF-IR: insulin-like growth factor–insulin receptor; IGFBP: insulin-like growth factor binding protein. † This was a non-randomized controlled trial.