Benefits of a low intensity exercise programme during haemodialysis sessions in elderly patients

Abstract

Background: Elderly patients on haemodialysis (HD) are a steadily increasing group. They show a high complexity, dependency and comorbidity. Multiple benefits from exercise in HD patients have been reported; however, they have not been specifically evaluated in an elderly population. Objective: To assess the effect of an adapted low intensity intradialytic exercise programme on muscle strength, functional capacity and health-related quality of life in our elderly patients (>80 years) on HD. Materials and methods: HD patients were non-randomly assigned to an exercise training group (E) or a control group (C) in a 12-week single-centre prospective study. E included a combined exercise programme using balls, weights, elastic bands and cycle movements in the first 2 h of HD sessions. C group patients received standard HD care. Endpoints were: (1) main biochemical data; (2) maximum quadriceps length strength (MQLS) and hand-grip (HG); (3) functional capacity tests: “Sit to stand to sit” (STS10) and “6-min walking test” (6MWT); (4) Beck Depressive Inventory (BDI); and (5) health-related quality of life questionnaire: EuroQol-5D (EQ-5D). Results: A total of 22 patients were included (50% men). Mean age was 83.2 years; patients had received HD for 44.1 months. Charlson index was 9.5. Main aetiology was diabetes mellitus (36.4%). Eleven patients were assigned to E group and 11 to C group. No related adverse effects were observed. At the end of the study, E group showed an overall improvement in tests (*p < 0.05): MQLS 10.5 ± 7.6 vs. 12.9 ± 10.1 kg, HG* 16.6 ± 8.7 vs. 18.2 ± 8.9 kg, STS10* 29.9 ± 10.6 vs. 25 ± 7.87 s, 6MWT* 14.6%, 234.4 vs. 274.7 m, BDI* 14.4 ± 11.5 vs. 11.7 ± 10.8 and EQ-5D 49 ± 19.1 vs. 59.5 ± 20.3. No similar changes were observed in C group. Significant differences between groups were also found for HG, MQLS, STS10, 6MWT, BDI and EQ-5D. No significant changes were found in biochemical and anthropometric data, antidepressant treatment or suitable dialysis parameters at the end of the study. Conclusions: (1) An adapted low intensity exercise programme improved muscle strength, functional capacity and health-related quality of life in our elderly patients on HD. (2) Our results highlight the benefits from exercise in HD patients even in this elderly population. (3) In elderly patients on HD, it is worth considering an adapted low intensity intradialytic exercise programme as a part of a comprehensive care.

Keywords

• Exercise
• Elderly
• Haemodialysis