Walking program improves quality of life and physical performance in dialysis patients

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).

A team led by Carmine Zoccali, MD from Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, Italy (CNR-IFC), and Fabio Manfredini, MD, University of Ferrara, and Francesca Mallamaci, MD, from Reggio Cal Renal and Transplantation Unit and CNR, randomized 296 dialysis patients to normal physical activity or a low intensity exercise program that included 20 minutes of walking at low-moderate speed every second day and of gradually increasing intensity over six months.

After six months, the distance covered during a six-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; six months 324 m). Similarly, the five times sit-to-stand test time improved in the exercise group average time: baseline 20.5 seconds; six months 18.2 seconds) but not in the control group (baseline 20.9 seconds; six 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 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.”