The effect of exercise training on arterial stiffness, physical function and self-reported health in haemodialysis patients

Haemodialysis patients show reduced physical function and greater risk of increased arterial stiffness because of hypertension, metabolic disturbances, and vascular calcification. Exercise interventions potentially could improve their vascular risk profile. This randomized controlled study compared the effects of six months of supervised intradialytic exercise training versus home-based exercise training or usual care on arterial stiffness, physical function and self-reported health in 70 haemodialysis patients. Intradialytic-exercise patients trained three times/wk for six months on a cycle ergometer and home-based-exercise patients followed a walking program to achieve the same weekly physical activity. Usual-care patients received no specific intervention. Primary outcome measures were distance travelled during a six-minute walk test and aortic pulse wave velocity. Secondary outcome measures included augmentation index (augmentation pressure as a percentage of central pulse pressure), peripheral (brachial) and central blood pressures (measured noninvasively using radial tonometry), physical activity, and self-reported physical functioning. Following six months of exercise intervention, there were no significant differences between changes in six-minute walk test distance (intradialytic exercise, +14%; home-based exercise, +11%; usual care, +5%), pulse wave velocity (intradialytic exercise, –4%; home-based exercise, –2%; usual care, –5%), or any secondary outcome measure. In conclusion, there were no differences between intradialytic or home-based exercise training and usual care for vascular parameters, physical function or self-reported health in haemodialysis patients after the six-month intervention