Simple walking program provides physical and mental benefits to dialysis patients

Highlight

• A simple home-based walking program improved physical capacity and quality of life in patients undergoing long-term dialysis.
• Many patients on dialysis get little or no exercise.

Washington, DC (December 1, 2016) -- In a recent study, a simple exercise program carried out at home improved dialysis patients' walking performance and quality of life. The findings appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

Studies have suggested that physical exercise can provide benefits for dialysis patients. To see if something as simple as walking may have positive effects, a team led by Carmine Zoccali, MD (CNR-IFC, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Italy), along with Fabio Manfredini, MD, (University of Ferrara), and Francesca Mallamaci, MD (Reggio Cal Renal and Transplantation Unit and CNR) randomized 296 dialysis patients to normal physical activity or a low intensity exercise program--20 minutes of walking at low-moderate speed every second day--of gradually increasing intensity over 6 months (https://www.youtube.com/watch?v=ki8YX_t-0jA).

After 6 months, the distance covered during a 6-minute walking test improved in the exercise group (average distance: baseline 328 m; 6 months 367 m) but not in the control group (baseline 321 m; 6 months 324 m). Similarly, the 5 times sit-to-stand test time improved in the exercise group average time: baseline 20.5 seconds; 6 months 18.2 seconds) but not in the control group (baseline 20.9 seconds; 6 months 20.2 seconds). Cognitive function and quality of scores improved significantly in the exercise arm compared with the control arm.

"Poor physical functioning is perhaps the most pervasive and disabling disturbance in patients with advanced kidney disease who are on chronic dialysis," said Dr. Zoccali. "While the effect of regular physical exercise training on physical performance in selected dialysis patients studied in standardized experimental settings in the laboratory is well documented, how exercise training should be articulated and implemented still remains an open problem. Our study shows that simple, home-based exercise programs hold potential for improving physical functioning in dialysis patients."

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Study co-authors include Graziella D'Arrigo, Rossella Baggetta, Davide Bolignano, Claudia Torino, Nicola Lamberti, Silvio Bertoli, Daniele Ciurlino, Lisa Rocca-Rey, Antonio Barill, Yuri Battaglia, Renato Rapanà, Alessandro Zuccalà, Graziella Bonanno, Pasquale Fatuzzo, Francesco Rapisarda, Stefania Rastelli, Fabrizio Fabrizi, Piergiorgio Messa Luciano De Paola, Luigi Lombardi, Adamasco Cupisti, Giorgio Fuiano, Gaetano Lucisano, Chiara Summaria, Michele Felisatti, Enrico Pozzato, Anna Maria Malagoni, Pietro Castellino, Filippo Aucella, Samar Abd ElHafeez, Pasquale Fabio Provenzano, Giovanni Tripepi, and Luigi Catizone.

Disclosures: The authors reported no financial disclosures.

The article, entitled "Exercise in Dialysis Patients: A Multi-Center, Randomized Clinical Trial," will appear online at http://jasn.asnjournals.org/ on December 1, 2016; doi:10.1681/ASN.2016030378.

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