نشریه علوم زیستی ورزشی

تأثیر تمرینات هوازی حین دیالیز بر شاخص پایی- بازویی (ABI)، کیفیت زندگی و کفایت دیالیز بیماران همودیالیزی

نوع مقاله : مقاله پژوهشی

نویسندگان

منیر نصیرزاده 1
رقیه فخرپور 2
حمید طیبی خسروشاهی 3
مجید مبصری 4

1 گروه علوم ورزشی، دانشکدۀ علوم تربیتی و روانشناسی، دانشگاه شهید مدنی آذربایجان، تبریز، ایران.

2 نویسنده مسوول، گروه علوم ورزشی، دانشکدۀ علوم تربیتی و روانشناسی، دانشگاه شهید مدنی آذربایجان، تبریز، ایران.

3 مرکز تحقیقات بیماری‌های کلیوی، دانشگاه علوم پزشکی تبریز، تبریز، ایران.

4 مرکز تحقیقات بیماری‌های غدد درون‌ریز، دانشگاه علوم پزشکی تبریز، تبریز، ایران

https://doi.org/10.22059/jsb.2023.352110.1561
چکیده
مقدمه: بیماری شریان محیطی، بخش مهمی از عوارض بیماری مزمن کلیه را تشکیل می‌دهد. اندازه‌گیری شاخص پایی-بازویی (ABI) معتبرترین روش تشخیص این بیماری است. بر اساس بررسی‌ها فعالیت بدنی می‌تواند با تأثیر بر عملکرد عروق و کارایی همودیالیز، بر وضعیت جسمانی و کیفیت زندگی بیماران همودیالیزی تأثیر بگذارد. در پژوهش حاضر، تأثیر تمرین هوازی حین همودیالیز بر شاخص پایی- بازویی، کیفیت زندگی و کفایت دیالیز بررسی شد.
روش پژوهش: در این پژوهش 30 بیمار همودیالیزی (با میانگین سن 02/4± 56 سال) از مراکز درمانی دیالیز، انتخاب شدند. بیماران به دو گروه تمرین (15 نفر) و کنترل (15 نفر) تقسیم شدند. گروه تمرین در دورۀ 12 هفته‌ای تمرین هوازی (رکاب‌زنی در حالت درازکش) حین دیالیز شرکت کرد، اما گروه کنترل روال عادی درمان را سپری کرد. پیش و پس از پایان دورۀ تمرینی، داده‌های مربوط به اندازه‌گیری متغیرها جمع‌آوری شد و تجزیه‌وتحلیل آماری به‌وسیلۀ نرم‌افزار Spss صورت گرفت.
یافته‌ها: بین میانگین شاخص پایی-بازویی (0.018=P)، کفایت دیالیز (0.004=P)، کیفیت زندگی مرتبط با سلامتی (0.000=P)، عملکرد بدنی (0.000=P)، روابط (0.000=P) و کیفیت خواب (0.006=P) گروه تمرین و کنترل در پیش و پس از مداخله تفاوت معنا‌داری وجود داشت. همچنین بین تغییرات شاخص پایی-بازویی و کیفیت زندگی (0.05=P) و بین کفایت دیالیز و کیفیت زندگی (0.025=P) ارتباط معنا‌داری وجود دارد. با این حال بین شاخص پایی-بازویی و کفایت دیالیز ارتباط معنا‌داری مشاهده نشد (0.920=P).
نتیجه‌گیری: تمرین هوازی حین همودیالیز تأثیر معناداری بر کاهش شاخص پایی-بازویی، افزایش کفایت دیالیز و کیفیت زندگی بیماران دارد. ازاین‌رو این نوع تمرین می‌تواند به‌عنوان راهبرد مهم در کاهش بیماری قلبی و بهبود کیفیت زندگی بیماران استفاده شود.

کلیدواژه‌ها

بیماران همودیالیزی
تمرینات هوازی
شاخص پایی- بازویی
کفایت دیالیز
کیفیت زندگی
موضوعات

عنوان مقاله English

The Effect of Intradialytic Aerobic Exercise on Ankle-Brachial Index, Quality of life, and Dialysis Adequacy of Hemodialysis Patients

نویسندگان English

Monir Nasirzadeh 1
Roghayeh Fakhrpour 2
Hamid Tayebi Khosroshahi 3
Majid Mobasseri 4
1 Department of Sports Sciences, Faculty of Educational Sciences and Psychology, Azerbaijan Shahid Madani University, Tabriz, Iran.
2 Corresponding Author: Department of Sports Sciences, Faculty of Educational Sciences and Psychology, Azerbaijan Shahid Madani University , Tabriz, Iran.
3 Endocrine Research Center, Tabriz University of Medical Science, Tabriz, Iran.
4 Endocrine Diseases Research Center, Tabriz University of Medical Sciences, Iran.
چکیده English

Introduction: Peripheral artery disease is an important part of the complications of chronic kidney disease. Measuring Ankle-Brachial Index (ABI) is the most reliable method of diagnosing this disease. According to studies, physical activity can affect the physical condition and quality of life of hemodialysis patients by affecting the function of blood vessels and the efficiency of hemodialysis. In this study, the effect of intradialytic aerobic exercise on ABI, quality of life, and dialysis adequacy was investigated.
Methods: In this study, 30 hemodialysis patients (with a mean age of 56 ± 4.02 years) were selected from dialysis treatment centers. Patients were divided into two Exercise (15 people) and Control (15 people) groups. The exercise group participated in 12 weeks of aerobic exercise (recumbent pedaling) during dialysis, but the control group underwent the usual treatment routine. Before and after the end of the exercise period, measured data were collected and statistical analysis was performed using SPSS software.
Results: Results: Results show that there was a significant difference in the mean ABI (P=0.018), dialysis adequacy (P=0.004), health-related quality of life (P=0.000), physical performance (P=0.000), relationships (P=0.000) and sleep quality (P=0.006) between the Exercise and Control groups before and after the intervention. Also, There was a significant relationship between ABI changes and quality of life (P=0.05) and between dialysis adequacy and quality of life (P=0.025), but no significant relationship was observed between ABI and dialysis adequacy (P=0/920).
Conclusion: Intradialytic Aerobic exercise has a significant effect on reducing ABI, increasing dialysis adequacy, and the patient's quality of life. Therefore, this type of exercise can be used as an important strategy to reduce heart disease and improve the quality of life of hemodialysis patients.

کلیدواژه‌ها English

Aerobic Training
ankle-Brachial Index (ABI)
Dialysis Adequacy
Hemodialysis
Quality of life
  1. Naroie S, Naji SA, Abdeyazdan GH, Dadkani E. Effect of applying self-care orem model on quality of life in the patient under hemodialysis. Zahedan Journal of Research in Medical Sciences. 2012;14(1)140-176.
  2. Hadadian F, Sohrabi N, Farokhpayam M, Farokhpayam H, Towhidi F, Fayazi S, et al. The effects of transcutaneous electrical acupoint stimulation (TEAS) on fatigue in haemodialysis patients. Journal of Clinical and Diagnostic Research: JCDR. 2016;10(9):YC01.
  3. George JA, Gounden V. Novel glomerular filtration markers. Advances in clinical chemistry. 2019;88:91-119.
  4. Mollahadi M, Tayyebi A, Ebadi A, Daneshmandi M. Comparison between anxiety, depression and stress in hemodialysis and kidney transplantation patients. Iran J Crit Care Nurs. 2010;2(4):153-6.
  5. Shannon JA, Smith HW. The excretion of inulin, xylose and urea by normal and phlorizinized man. The Journal of clinical investigation. 1935;14(4):393-401.
  6. Touchberry CD, Ernsting M, Haff G, Kilgore JL. Training alterations in elite cyclists may cause transient changes in glomerular filtration rate. Journal of sports science & medicine. 2004;3(YISI 1):28.
  7. Poortmans JR, Ouchinsky M. Glomerular filtration rate and albumin excretion after maximal exercise in aging sedentary and active men. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2006;61(11):1181-5.
  8. Allen PJ. Creatine metabolism and psychiatric disorders: Does creatine supplementation have therapeutic value? Neuroscience & Biobehavioral Reviews. 2012;36(5):1442-62.
  9. Barsoum RS. Chronic kidney disease in the developing world. New England Journal of Medicine. 2006;354(10):997-9.
  10. Tabatabaee MH, Savadkouhi F. Chronic Renal Failure in the children of Sistan and Balouchestan province. Zahedan Journal of Research in Medical Sciences. 2004;6(4).120-83
  11. Jahanpeyma P, Makhdoomi K, Sajadi SA. The effect of nutrition education program on biochemical parameters among patients with chronic kidney disease undergoing hemodialysis.2017:10(3),230-112.
  12. Pourebrahimi M, Rahimi A, Tayebi A, Ebrahimi H. The effect of consuming oral Vitamin C on exhaustion of hemodialysis patient caregivers. 2013.12(3)95-100
  13. Salimi SH, Tayebi A. A survey on relationships between mental health related factors (stress, depression, anxiety) and marital satisfaction in hemodialysis patients. 2010.142(12)335-344
  14. Daugirdas JT, Blake PG, Ing TS. Handbook of dialysis: Lippincott Williams & Wilkins; 2012.
  15. Solymani M, Askari M. Critical care nursing in dialysis, CCU and ICU. Tehran: Bushehr Publication. 2004.
  16. Oshvandi K, Kavyannejad R, Borzuo R, Gholyaf M, Salavati M. Dialysis adequacy with high flux membrane in hemodialysis patients at Shahid Beheshti hospital, Hamedan. Nursing And Midwifery Journal. 2012;10(4):0-10.
  17. Perl J, Dember LM, Bargman JM, Browne T, Charytan DM, Flythe JE, et al. The use of a multidimensional measure of dialysis adequacy—moving beyond small solute kinetics. Clinical Journal of the American Society of Nephrology. 2017;12(5):839-47.
  18. Steyaert S, Holvoet E, Nagler E, Malfait S, Van Biesen W. Reporting of “dialysis adequacy” as an outcome in randomised trials conducted in adults on haemodialysis. PloS one. 2019;14(2):e0207045.
  19. Sultania P, Sharma SK, Sharma S. Adequacy of hemodialysis in Nepalese patients undergoing maintenance hemodialysis. Journal of Nepal Medical Association. 2009;48(173): 164-85.
  20. Shahgholian N, Salehi A, Mortazavi M. Impact of stepwise sodium and ultra filtration profiles and dialysis solution flow rate profile on dialysis adequacy. Iranian Journal of Nursing and Midwifery Research. 2014;19(5):537.
  21. Borzou R, Ghlyaf M, Amini R, Zandiyan M, Torkaman B. Evaluation of dialysis adequacy in hemodialysis Ekbatan Hospital. Hamadan. 2006;13(4):53-7.
  22. Raisifar A. Torab pour M, Mohseni Zad P. Review adequacy of dialysis in hemodialysis patients referred to the center city of Abadan in the. 2006;2009.4(2):95-72.
  23. Meira, Fernanda S., Carlos E. POLI DE FIGUEIREDO, and Ana E. Figueiredo. "Influence of sodium profile in preventing complications during hemodialysis." Hemodialysis International. 2007;11:S29-S32.
  24. Johansen KL. Exercise in the end-stage renal disease population. Journal of the American Society of Nephrology. 2007;18(6):1845-54.
  25. Fakhrpour R, Ebrahim K, Ahmadizad S, Tayebi Khosroshahi H. Effects of combination training on Fetuin A, C-Reactive protein and some biochemical parameters in hemodialysis patients. Sport Physiology. 2016;8(32):115-30.
  26. Palazzuoli A, Masson S, Ronco C, Maisel A. Clinical relevance of biomarkers in heart failure and cardiorenal syndrome: the role of natriuretic peptides and troponin. Heart failure reviews. 2014;19(2):267-84.
  27. Cheung AK, Sarnak MJ, Yan G, Dwyer JT, Heyka RJ, Rocco MV, et al. Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney international. 2000;58(1):353-62.
  28. Boey JH, Way LW. Acute cholangitis. Annals of Surgery. 1980;191(3):264.
  29. Berger JS, Hochman J, Lobach I, Adelman MA, Riles TS, Rockman CB. Modifiable risk factor burden and the prevalence of peripheral artery disease in different vascular territories. Journal of vascular surgery. 2013;58(3):673-81. e1.

 

  1. Barbosa JP, Farah BQ, Chehuen M, Cucato GG, Farias Júnior JC, Wolosker N, et al. Barriers to physical activity in patients with intermittent claudication. International journal of behavioral medicine. 2015;22(1):70-6.
  2. Regensteiner JG, Hiatt WR, Coll JR, Criqui MH, Treat-Jacobson D, McDermott MM, et al. The impact of peripheral arterial disease on health-related quality of life in the Peripheral Arterial Disease Awareness, Risk, and Treatment: New Resources for Survival (PARTNERS) Program. Vascular medicine. 2008;13(1):15-24.
  3. O'hare A, Johansen K. Peripheral vascular disease in end-stage renal disease patients. SAGE Publications Sage UK: London, England; 2002. p. 1123-7.
  4. Newman AB, Shemanski L, Manolio TA, Cushman M, Mittelmark M, Polak JF, et al. Ankle-arm index as a predictor of cardiovascular disease and mortality in the Cardiovascular Health Study. Arteriosclerosis, thrombosis, and vascular biology. 1999;19(3):538-45.
  5. Foley TR, Armstrong EJ, Waldo SW. Contemporary evaluation and management of lower extremity peripheral artery disease. Heart. 2016;102(18):1436-41.
  6. Aboyans V, Criqui MH, Abraham P, Allison MA, Creager MA, Diehm C, et al. Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012;126(24):2890-909.
  7. Leeper NJ, Myers J, Zhou M, Nead KT, Syed A, Kojima Y, et al. Exercise capacity is the strongest predictor of mortality in patients with peripheral arterial disease. Journal of vascular surgery. 2013;57(3):728-33.
  8. Chang P, Nead KT, Olin JW, Myers J, Cooke JP, Leeper NJ. Effect of physical activity assessment on prognostication for peripheral artery disease and mortality. Mayo Clin Proc. 2015;90(3):339-45.
  9. Parmenter BJ, Raymond J, Dinnen P, Singh MAF. A systematic review of randomized controlled trials: walking versus alternative exercise prescription as treatment for intermittent claudication. Atherosclerosis. 2011;218(1):1-12.
  10. Parmenter BJ, Raymond J, Fiatarone Singh MA. The effect of exercise on fitness and performance-based tests of function in intermittent claudication: a systematic review. Sports medicine. 2013;43(6):513-24.
  11. Gerhard-Herman MD, Gornik HL, Barrett C, Barshes NR, Corriere MA, Drachman DE, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology. 2017;69(11):e71-e126.
  12. Carter SA. Response of ankle systolic pressure to leg exercise in mild or questionable arterial disease. New England Journal of Medicine. 1972;287(12):578-82.
  13. Stein R, Hriljac I, Halperin JL, Gustavson SM, Teodorescu V, Olin JW. Limitation of the resting ankle-brachial index in symptomatic patients with peripheral arterial disease. Vascular medicine. 2006;11(1):29-33.
  14. Straznicky NE, Grima MT, Lambert EA, Eikelis N, Dawood T, Lambert GW, et al. Exercise augments weight loss induced improvement in renal function in obese metabolic syndrome individuals. Journal of hypertension. 2011;29(3):553-64.
  15. Chen JL, Godfrey S, Ng TT, Moorthi R, Liangos O, Ruthazer R, et al. Effect of intra-dialytic, low-intensity strength training on functional capacity in adult haemodialysis patients: a randomized pilot trial. Nephrology Dialysis Transplantation. 2010;25(6):1936-43.
  16. Rajagopalan S, Dellegrottaglie S, Furniss AL, Gillespie BW, Satayathum S, Lameire N, et al. Peripheral arterial disease in patients with end-stage renal disease: observations from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Circulation. 2006;114(18):1914-22.
  17. Lippi G, Schena F, Salvagno G, Tarperi C, Montagnana M, Gelati M, et al. Acute variation of estimated glomerular filtration rate following a half-marathon run. International journal of sports medicine. 2008;29(12):948-51.
  18. Watson L, Ellis B, Leng GC. Exercise for intermittent claudication. Cochrane database of systematic reviews. 2008:8(4):118-86.
  19. Fakhry F, van de Luijtgaarden KM, Bax L, den Hoed PT, Hunink MM, Rouwet EV, et al. Supervised walking therapy in patients with intermittent claudication. Journal of vascular surgery. 2012;56(4):1132-42.
  20. Golbidi S, Laher I. Exercise and the cardiovascular system. Cardiology research and practice. 2012;13(5)96-43.
  21. Rossi AP, Burris DD, Lucas FL, Crocker GA, Wasserman JC. Effects of a renal rehabilitation exercise program in patients with CKD: a randomized, controlled trial. Clinical journal of the American Society of Nephrology. 2014;9(12):2052-8.
  22. Salehi A, Shahgholian N, Mortazavi M. Investigation of the effects of stepwise sodium and ultrafiltration profile on dialysis adequacy. 2016:63(4).247-252
  23. Zeraati A, Naghibi M, Jabbari Noghabi H. Investigating factors affecting the adequacy of dialysis in patients undergoing hemodialysis. Med J Mashhad Uni Med Sci. 2008;99(51):45-52.
  24. Parsons TL, Toffelmire EB, King-VanVlack CE. Exercise training during hemodialysis improves dialysis efficacy and physical performance. Archives of physical medicine and rehabilitation. 2006;87(5):680-7.
  25. Tayyebi A, Babahaji M, Sadeghi Sherme M, Ebadi A, Eynollahi B. Study of the effect of Hatha Yoga exercises on dialysis adequacy. Iran J Crit Care Nurs. 2012;4:183-90.
  26. Fallahi M, Shahidi S, Farajzadegan Z. Effect of exercise during hemodialysis on dialysis efficiency, serum phosphorus levels, hemoglobin, and blood pressure and compare the two different exercise program in patients. J Isfahan Med School. 2008;26:152-61.
  27. Borzou R, Ghalyaf M, Amini R, Zandiyan M, Torkaman B. Effect of increased blood flow on the amount of dialysis adequacy in hemodialysis pationts. Shahrekord Univ Med Sci J. 2009;8(2):60-6.
  28. Knaepen K, Goekint M, Heyman EM, Meeusen R. Neuroplasticity—exercise-induced response of peripheral brain-derived neurotrophic factor. Sports medicine. 2010;40(9):765-801.
  29. Adequacy PD. Clinical practice guidelines for peritoneal adequacy, update 2006. American journal of kidney diseases: the official journal of the National Kidney Foundation. 2006;48:S91-S7.
  30. Ghafourifard M, Mehrizade B, Hassankhani H, Heidari M. Hemodialysis patients perceived exercise benefits and barriers: the association with health-related quality of life. BMC nephrology. 2021;22(1):1-9.
  31. Wilund KR, Jeong JH, Greenwood SA, editors. Addressing myths about exercise in hemodialysis patients. Seminars in dialysis; 2019: Wiley Online Library.
  32. Mustata S, Groeneveld S, Davidson W, Ford G, Kiland K, Manns B. Effects of exercise training on physical impairment, arterial stiffness and health-related quality of life in patients with chronic kidney disease: a pilot study. International urology and nephrology. 2011;43(4):1133-41.
  33. Kutner NG, Zhang R, Huang Y, Johansen KL. Depressed mood, usual activity level, and continued employment after starting dialysis. Clinical Journal of the American Society of Nephrology. 2010;5(11):2040-5.
  34. Nonoyama ML, Brooks D, Ponikvar A, Jassal SV, Kontos P, Devins GM, et al. Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study. International urology and nephrology. 2010;42(4):1125-30.
  35. Jayaseelan G, Bennett PN, Bradshaw W, Wang W, Rawson H. Exercise benefits and barriers: the perceptions of people receiving hemodialysis. Nephrology Nursing Journal. 2018;45(2):185-219.
  36. Falahi M, SHAHIDI S, Farajzadegan Z. The effect of intradialytic exercise on dialysis efficacy, serum phosphate, hemoglobin and blood pressure control and comparison between two exercise programs in hemodialysis patients. 2008:38(12):152-161.
  37. Parsons TL, Toffelmire EB, King-VanVlack CE. The effect of an exercise program during hemodialysis on dialysis efficacy, blood pressure and quality of life in end-stage renal disease (ESRD) patients. Clinical nephrology. 2004;61(4):261-74.
  38. Kalender N, Tosun N. Determination of the relationship between adequacy of dialysis and quality of life and self-care agency. J Clin Nurs. 2014;23(5-6):820-8.

  • تاریخ دریافت 17 آذر 1401
  • تاریخ بازنگری 26 دی 1401
  • تاریخ پذیرش 18 بهمن 1401

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