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Exercise Training in Hemodialysis Patients: A Systematic Review and Meta-Analysis.
MedLine Citation:
PMID:  21557787     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background  We quantified baseline and observed change in peak VO(2) , quality of life, cardiac function, strength and energy intake following exercise training in hemodialysis (HD) patients and optimal exercise delivery for producing greatest adherence, safety and patient improvements. Methods  A systematic literature search was completed in August 2010 to identify randomized, controlled trials of exercise training studies in HD patients. A subsequent meta-analysis was conducted and the search repeated in December 2010. Results  Fifteen studies, yielding 565 patients were included. Baseline, peak VO(2) values were 70% of age-predicted values, exercise intervention patients improved post-training peak VO(2) to 88% predicted. Exercise training produced mean 26±12% improvements in 8 studies that reported peak VO(2) , Mean Difference (MD) 5.22 mlO(2) .kg(-1) .min(-1) (95% CI 3.86, 6.59, p < .00001). Equivocal results for change in SF-36 scores were reported post-training. Heart rate variability was improved after exercise training MD 16.34 (95% CI 8.3, 24.3, p < .0001). Significant improvements in lean body mass, quadriceps muscle area, knee extension, hip abduction and flexion strength were also reported (all P < 0.0001). Exercise training appears safe, with no deaths directly associated with exercise in 28,400 patient-hours and no differences in withdrawal rates between exercise and control participants, p = 0.98. Exercise training for 6 months or more conveyed larger improvements in peak VO(2) than shorter programs. Data indicate about 25% of patients were excluded from exercise training studies for medical reasons. Conclusions  Exercise training is safe and imparts large improvements in peak VO(2) , and heart rate variability.
Authors:
Neil Smart; Michael Steele
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-9
Journal Detail:
Title:  Nephrology (Carlton, Vic.)     Volume:  -     ISSN:  1440-1797     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9615568     Medline TA:  Nephrology (Carlton)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 The Authors. Nephrology © 2011 Asian Pacific Society of Nephrology.
Affiliation:
Dept. Exercise Science, University New England, NSW 2350, Australia Faculty of Health Science and Medicine, Bond University, QLD 4229 Australia.
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