Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus
This randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 ± 11.3 years old, CAN and type...
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MDPI AG
2023-06-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/6/1394 |
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| author | Vassiliki Michou Maria Nikodimopoulou Vassilios Liakopoulos Maria Anifanti Aikaterini Papagianni Pantelis Zembekakis Asterios Deligiannis Evangelia Kouidi |
| author_facet | Vassiliki Michou Maria Nikodimopoulou Vassilios Liakopoulos Maria Anifanti Aikaterini Papagianni Pantelis Zembekakis Asterios Deligiannis Evangelia Kouidi |
| author_sort | Vassiliki Michou |
| collection | DOAJ |
| description | This randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 ± 11.3 years old, CAN and type II Diabetes Mellitus (DM-II)), were randomly assigned into two groups: A (n<sub>1</sub> = 13 KTRs), who underwent a home-based exercise training program for 6 months, and B (n<sub>2</sub> = 12 KTRs), who were assessed at the end of the study. A cardiopulmonary exercise testing (CPET), sit-to-stand test in 30 s (30-s STS), isokinetic muscle strength dynamometry, and 24-h electrocardiographic monitoring were applied to all participants, both at the baseline and at the end of the clinical trial. At first, there were no statistically significant differences between groups. After 6 months, group A showed higher values in exercise time by 8.7% (<i>p</i> = 0.02), VO<sub>2</sub>peak by 7.3% (<i>p</i> < 0.05), 30-s STS by 12.0% (<i>p</i> < 0.05), upper limb strength by 46.1% (<i>p</i> < 0.05), and lower limb strength by 24.6% (<i>p</i> = 0.02), respectively, compared to the B group. Furthermore, inter-group changes at the end of the 6-month study indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 30.3% (<i>p</i> = 0.01), root mean square of successive differences between normal heartbeats (rMSSD) by 32.0% (<i>p</i> = 0.03), number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (pNN50) by 29.0% (<i>p</i> = 0.04), high frequency (HF (ms<sup>2</sup>)) by 21.6% (<i>p</i> < 0.05), HF (n.u.) by 48.5% (<i>p</i> = 0.01), and turbulence slope (TS) by 22.5% (<i>p</i> = 0.02), and decreased the low frequency (LF (ms<sup>2</sup>)) by 13.2% (<i>p</i> = 0.01), LF (n.u.) by 24.9% (<i>p</i> = 0.04), and LF/HF ratio by 24% (<i>p</i> = 0.01), compared to group B. Linear regression analysis after the 6-month study showed that there was a strong positive correlation between VO<sub>2</sub>peak and SDNN (r = 0.701, <i>p</i> < 0.05) in group A. Moreover, multiple regression analysis showed that KTRs’ participation in the exercise program showed favorable modifications to sympathovagal balance and aerobic capacity, as measured with SDNN and VO2peak, respectively. To summarize, diabetic KTRs’ cardiac autonomic function and functional capacity can be improved after a home-based long-term exercise training program. |
| first_indexed | 2024-03-11T02:14:39Z |
| format | Article |
| id | doaj.art-9e633130515d45bb973ce4380ce2fe94 |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T02:14:39Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-9e633130515d45bb973ce4380ce2fe942023-11-18T11:18:41ZengMDPI AGLife2075-17292023-06-01136139410.3390/life13061394Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes MellitusVassiliki Michou0Maria Nikodimopoulou1Vassilios Liakopoulos2Maria Anifanti3Aikaterini Papagianni4Pantelis Zembekakis5Asterios Deligiannis6Evangelia Kouidi7Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, GreeceTransplant Surgery Clinic of Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, GreeceDivision of Nephrology and Hypertension, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, GreeceSports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, GreeceDepartment of Nephrology, Hippokration Hospital, Aristotle University, 54642 Thessaloniki, GreeceDivision of Internal Medicine, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, GreeceSports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, GreeceSports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, GreeceThis randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 ± 11.3 years old, CAN and type II Diabetes Mellitus (DM-II)), were randomly assigned into two groups: A (n<sub>1</sub> = 13 KTRs), who underwent a home-based exercise training program for 6 months, and B (n<sub>2</sub> = 12 KTRs), who were assessed at the end of the study. A cardiopulmonary exercise testing (CPET), sit-to-stand test in 30 s (30-s STS), isokinetic muscle strength dynamometry, and 24-h electrocardiographic monitoring were applied to all participants, both at the baseline and at the end of the clinical trial. At first, there were no statistically significant differences between groups. After 6 months, group A showed higher values in exercise time by 8.7% (<i>p</i> = 0.02), VO<sub>2</sub>peak by 7.3% (<i>p</i> < 0.05), 30-s STS by 12.0% (<i>p</i> < 0.05), upper limb strength by 46.1% (<i>p</i> < 0.05), and lower limb strength by 24.6% (<i>p</i> = 0.02), respectively, compared to the B group. Furthermore, inter-group changes at the end of the 6-month study indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 30.3% (<i>p</i> = 0.01), root mean square of successive differences between normal heartbeats (rMSSD) by 32.0% (<i>p</i> = 0.03), number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (pNN50) by 29.0% (<i>p</i> = 0.04), high frequency (HF (ms<sup>2</sup>)) by 21.6% (<i>p</i> < 0.05), HF (n.u.) by 48.5% (<i>p</i> = 0.01), and turbulence slope (TS) by 22.5% (<i>p</i> = 0.02), and decreased the low frequency (LF (ms<sup>2</sup>)) by 13.2% (<i>p</i> = 0.01), LF (n.u.) by 24.9% (<i>p</i> = 0.04), and LF/HF ratio by 24% (<i>p</i> = 0.01), compared to group B. Linear regression analysis after the 6-month study showed that there was a strong positive correlation between VO<sub>2</sub>peak and SDNN (r = 0.701, <i>p</i> < 0.05) in group A. Moreover, multiple regression analysis showed that KTRs’ participation in the exercise program showed favorable modifications to sympathovagal balance and aerobic capacity, as measured with SDNN and VO2peak, respectively. To summarize, diabetic KTRs’ cardiac autonomic function and functional capacity can be improved after a home-based long-term exercise training program.https://www.mdpi.com/2075-1729/13/6/1394kidney transplant recipientscardiac autonomic neuropathydiabetic kidney disease exercisefunctional capacity |
| spellingShingle | Vassiliki Michou Maria Nikodimopoulou Vassilios Liakopoulos Maria Anifanti Aikaterini Papagianni Pantelis Zembekakis Asterios Deligiannis Evangelia Kouidi Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus Life kidney transplant recipients cardiac autonomic neuropathy diabetic kidney disease exercise functional capacity |
| title | Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus |
| title_full | Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus |
| title_fullStr | Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus |
| title_full_unstemmed | Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus |
| title_short | Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus |
| title_sort | home based exercise training and cardiac autonomic neuropathy in kidney transplant recipients with type ii diabetes mellitus |
| topic | kidney transplant recipients cardiac autonomic neuropathy diabetic kidney disease exercise functional capacity |
| url | https://www.mdpi.com/2075-1729/13/6/1394 |
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