Progressive exercise for anabolism in kidney disease (PEAK): A randomized, controlled trial of resistance training during hemodialysis
Progressive exercise for anabolism in kidney disease (PEAK): A randomized, controlled trial of resistance training during hemodialysis
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DOI：
10.1681/asn.2006121329
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发表时间：
2007-05-01
影响因子：
13.6
通讯作者：
Singh, Maria Fiatarone
中科院分区：
文献类型：
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作者：
Cheema, Bobby;Abas, Haifa;Singh, Maria Fiatarone
骨骼肌萎缩在接受维持性血液透析治疗的ESRD患者中是常见和潜伏的。本研究的目的是确定在常规血液透析治疗期间进行12周的高强度进行性阻力训练（PRT）是否能改善骨骼肌的数量和质量。49名患者（62.6 +/- 14.2年；0.3 - 16.7年透析）从St. George公立医院（悉尼，澳大利亚）的门诊血液透析部门招募。患者被随机分为PRT +常规护理组（n = 24）或常规护理对照组（n = 25）。PRT组在常规血液透析治疗期间，使用自由重量进行两组10次高强度运动（博格量表15至17/20），每周三次，持续12周。主要结果包括通过计算机断层扫描评估大腿肌肉数量（横截面积[CSA]）和质量（通过衰减评估肌内脂质含量）。次要结局包括肌力、运动能力、体围、促炎细胞因子c反应蛋白和生活质量。两组间肌肉CSA变化无统计学差异。然而，与不运动的对照组相比，PRT组在肌肉衰减、肌肉力量、大腿中部和手臂中部围度、体重和c反应蛋白方面有统计学意义的改善。这些研究结果表明，ESRD患者仅通过在常规血液透析治疗期间进行12周的高强度PRT治疗即可改善骨骼肌质量并获得其他与健康相关的适应。可能需要更长的训练时间或更灵敏的分析技术来记录肌肉CSA的变化。
Skeletal muscle wasting is common and insidious in patients who receive maintenance hemodialysis treatment for the management of ESRD. The objective of this study was to determine whether 12 wk of high-intensity, progressive resistance training (PRT) administered during routine hemodialysis treatment could improve skeletal muscle quantity and quality versus usual care. Forty-nine patients (62.6 +/- 14.2 yr; 0.3 to 16.7 yr on dialysis) were recruited from the outpatient hemodialysis unit of the St. George Public Hospital (Sydney, Australia). Patients were randomized to PRT + usual care (n = 24) or usual care control only (n = 25). The PRT group performed two sets of 10 exercises at a high intensity (15 to 17/20 on the Borg Scale) using free weights, three times per week for 12 wk during routine hemodialysis treatment. Primary outcomes included thigh muscle quantity (cross-sectional area [CSA]) and quality (intramuscular lipid content via attenuation) evaluated by computed tomography scan. Secondary outcomes included muscle strength, exercise capacity, body circumference measures, proinflammatory cytokine C-reactive protein, and quality of life. There was no statistically significant difference in muscle CSA change between groups. However, there were statistically significant improvements in muscle attenuation, muscle strength, mid-thigh and mid-arm circumference, body weight, and C-reactive protein in the PRT group relative to the nonexercising control group. These findings suggest that patients with ESRD can improve skeletal muscle quality and derive other health-related adaptations solely by engaging in a 12-wk high-intensity PRT regimen during routine hemodialysis treatment sessions. Longer training durations or more sensitive analysis techniques may be required to document alterations in muscle CSA.