Rossella Baggetta 1 , Graziella D’Arrigo 1 , Claudia Torino 1 , Samar Abd ElHafeez 3 , Fabio Manfredini 2 , Francesca Mallamaci 1 , Carmine Zoccali 1 , Giovanni Tripepi , 1 , on behalf of the EXCITE Working group
20 October 2018
Older adults dialysis patients represent the frailest subgroup of the End Stage Renal Disease (ESRD) population and physical exercise program may mitigate the age-related decline in muscle mass and function.
Dialysis patients of the EXCITE trial aged > 65 years ( n = 115, active arm, n = 53; control arm, n = 62) were submitted in random order to a home based, low intensity physical exercise program. At baseline and 6 months after exercise training 6-min walking distance (6MWD) and 5-time sit-to-stand test (5STS) were performed, and quality of life (QoL) was tested.
The training program improved both the 6MWD (6-months: 327 ± 86 m versus baseline: 294 ± 74 m; P < 0.001) and the 5STS time (6-months: 19.8 ± 5.6 s versus baseline: 22.5 ± 5.1 s; P < 0.001) in the exercise group whereas they did not change in the control group ( P = 0.98 and 0.25, respectively). The between-arms differences (6 months-baseline) in the 6MWD (+ 34.0 m, 95% CI: 14.4 to 53.5 m) and in the 5STS time changes (− 1.9 s, 95% CI: -3.6 to − 0.3 s) were both statistically significant ( P = 0.001 and P = 0.024, respectively). The cognitive function dimension of QoL significantly reduced in the control arm ( P = 0.04) while it remained unchanged in the active arm ( P = 0.78) (between groups difference P = 0.05). No patient died during the trial and the training program was well tolerated.
This secondary analysis of the EXCITE trial shows that a home-based, exercise program improves physical performance and is well tolerated in elderly ESRD patients.