Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis
Abstract Background Several kinds of physical activities have been applied to improve the prognosis of patients with hemodialysis (HD). However, the comparative efficacy of physical activities on the outcomes in HD patients is still unknown. This study explored the effectiveness and safety of all ex...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | European Journal of Medical Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40001-023-01270-9 |
| _version_ | 1797577295231188992 |
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| author | Ning Ren Huiting Yang Zelin Cai Ruye Wang Zeng Wang Ying Zhao Chenyun Miao Yun Chen Yang Zhang Xingyu Zhu Hongyu Chen Qin Zhang |
| author_facet | Ning Ren Huiting Yang Zelin Cai Ruye Wang Zeng Wang Ying Zhao Chenyun Miao Yun Chen Yang Zhang Xingyu Zhu Hongyu Chen Qin Zhang |
| author_sort | Ning Ren |
| collection | DOAJ |
| description | Abstract Background Several kinds of physical activities have been applied to improve the prognosis of patients with hemodialysis (HD). However, the comparative efficacy of physical activities on the outcomes in HD patients is still unknown. This study explored the effectiveness and safety of all exercise types in HD patients. Methods We searched randomized clinical trials from the PubMed, EMBASE, and Cochrane Library databases. Physical exercises interventions included resistance exercise (RE), aerobic exercise (AE), electrical muscle stimulation (EMS), range of motion (ROM), resistance exercise + aerobic exercise (RE + AE), stretching exercise (STE), respiratory muscle training (RMT), peripheral muscle training (PMT), walking exercise (WE), or usual care/sham exercise (UC/SE). Primary outcomes were six-minute walk test (6-mwt) and quality of life (QOL). Secondary outcomes were Kt/V, VO2max, hemoglobin (Hb), C-reactive protein (CRP), interleukin-6 (IL-6), and systolic and diastolic blood pressure (sbp and dbp). Frequentist network meta-analysis with multivariate random effects models provided mean with 95% confidence intervals (95%CI). Results A total of 58 eligible studies were included. AE, RMT, and RE + AE significantly improved 6-mwt compared with UC/SE. SE was the worst intervention and reduced QOL much more than the UC/SE and other exercise types. AE and RE + AE were associated with higher VO2max, while ROM and RE + AE induced higher Hb levels. All physical activities did not elevate blood pressure, CRP and IL-6. Only ROM decreased sbp/dbp. CRP is significantly lower in RE. Conclusion Physical activities play a crucial role in the different outcomes of HD patients. They can be applied to specific area for their specific efficacy. |
| first_indexed | 2024-03-10T22:06:14Z |
| format | Article |
| id | doaj.art-4dcfe948f31c4056b58ef7e2bcc977e6 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-10T22:06:14Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-4dcfe948f31c4056b58ef7e2bcc977e62023-11-19T12:46:56ZengBMCEuropean Journal of Medical Research2047-783X2023-10-0128111110.1186/s40001-023-01270-9Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysisNing Ren0Huiting Yang1Zelin Cai2Ruye Wang3Zeng Wang4Ying Zhao5Chenyun Miao6Yun Chen7Yang Zhang8Xingyu Zhu9Hongyu Chen10Qin Zhang11Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)School of Public Health, Zhejiang Chinese Medical UniversitySchool of Life Sciences, Zhejiang Chinese Medical UniversityDepartment of Medical TCM Gynaecology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Department of Nephrology, Wenzhou Hospital of Integrated Traditional Chinese and Western MedicineDepartment of Nephrology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Department of Nephrology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Department of Medical TCM Gynaecology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine)Abstract Background Several kinds of physical activities have been applied to improve the prognosis of patients with hemodialysis (HD). However, the comparative efficacy of physical activities on the outcomes in HD patients is still unknown. This study explored the effectiveness and safety of all exercise types in HD patients. Methods We searched randomized clinical trials from the PubMed, EMBASE, and Cochrane Library databases. Physical exercises interventions included resistance exercise (RE), aerobic exercise (AE), electrical muscle stimulation (EMS), range of motion (ROM), resistance exercise + aerobic exercise (RE + AE), stretching exercise (STE), respiratory muscle training (RMT), peripheral muscle training (PMT), walking exercise (WE), or usual care/sham exercise (UC/SE). Primary outcomes were six-minute walk test (6-mwt) and quality of life (QOL). Secondary outcomes were Kt/V, VO2max, hemoglobin (Hb), C-reactive protein (CRP), interleukin-6 (IL-6), and systolic and diastolic blood pressure (sbp and dbp). Frequentist network meta-analysis with multivariate random effects models provided mean with 95% confidence intervals (95%CI). Results A total of 58 eligible studies were included. AE, RMT, and RE + AE significantly improved 6-mwt compared with UC/SE. SE was the worst intervention and reduced QOL much more than the UC/SE and other exercise types. AE and RE + AE were associated with higher VO2max, while ROM and RE + AE induced higher Hb levels. All physical activities did not elevate blood pressure, CRP and IL-6. Only ROM decreased sbp/dbp. CRP is significantly lower in RE. Conclusion Physical activities play a crucial role in the different outcomes of HD patients. They can be applied to specific area for their specific efficacy.https://doi.org/10.1186/s40001-023-01270-9HemodialysisEfficacyExerciseNetwork meta-analysis |
| spellingShingle | Ning Ren Huiting Yang Zelin Cai Ruye Wang Zeng Wang Ying Zhao Chenyun Miao Yun Chen Yang Zhang Xingyu Zhu Hongyu Chen Qin Zhang Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis European Journal of Medical Research Hemodialysis Efficacy Exercise Network meta-analysis |
| title | Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis |
| title_full | Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis |
| title_fullStr | Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis |
| title_full_unstemmed | Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis |
| title_short | Comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis: a systematic review and network meta-analysis |
| title_sort | comparative efficacy of nine exercise methods on the prognosis in chronic kidney disease patients with hemodialysis a systematic review and network meta analysis |
| topic | Hemodialysis Efficacy Exercise Network meta-analysis |
| url | https://doi.org/10.1186/s40001-023-01270-9 |
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