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      A Comparison of Intradialytic versus Out-of-Clinic Exercise Training Programs for Hemodialysis Patients

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          Abstract

          Background: Physical inactivity is prevalent and linked with a variety of unfavorable clinical outcomes in hemodialysis patients. To increase physical activity (PA) and improve quality of life in this population, intradialytic and out-of-clinic exercise interventions have been implemented in many studies. However, there is still a lack of consensus in the literature on which type of exercise intervention is more feasible and effective. Summary: This review provides a brief overview of intradialytic and out-of-clinic exercise protocols utilized in previous studies. We also examine data related to the feasibility of each approach, and their efficacy for improving cardiovascular health, muscle mass, strength, and physical function. Key Messages: The benefits from most intradialytic and out-of-center exercise training interventions published to date have been modest or inconsistent. Furthermore, neither appears to provide a significant advantage over the other in terms of benefits for cardiovascular health, muscle mass, strength, and physical function. A significant concern is that most intradialytic and out-of-center exercise interventions are mandated exercise prescriptions that include either endurance or resistance training exercises, performed at low-moderate intensities, for a total of 60–135 min of exercise/week. This volume, intensity, and variety of exercise are far less than what is recommended in most PA guidelines. This type of structured activity is also boring for most patients. To enhance the effectiveness of exercise interventions, we suggest using the intradialytic period to provide patients guidance on how they can best incorporate more activity into their lives, based on their individual needs and barriers.

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          Author and article information

          Journal
          BPU
          Blood Purif
          10.1159/issn.0253-5068
          Blood Purification
          S. Karger AG
          0253-5068
          1421-9735
          2020
          February 2020
          18 December 2019
          : 49
          : 1-2
          : 151-157
          Affiliations
          [_a] aDepartment of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
          [_b] bDivision of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
          Author notes
          *Kenneth R. Wilund, PhD, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 906 S. Goodwin Avenue, Urbana, IL 61801 (USA), E-Mail kwilund@illinois.edu
          Article
          503772 Blood Purif 2020;49:151–157
          10.1159/000503772
          31851985
          a56cf1ab-4971-44ed-ab17-5cc0d72d4e15
          © 2019 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 18 September 2019
          : 28 September 2019
          Page count
          Figures: 1, Tables: 1, Pages: 7
          Categories
          Review – Advances in CKD 2020

          Cardiovascular Medicine,Nephrology
          Exercise,Hemodialysis,End-stage kidney disease,Physical activity

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