Intradialytic Progressive Resistance Training for Maintenance Haemodialysis Patients

Study Overview
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Brief Summary
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The purpose of this study is to investigate the effects of a 12 week progressive resistance training during haemodialysis on muscle quantity and physical functioning in chronic kidney disease patients receiving maintenance haemodialysis. It is hypothesised, based on previous literature involving similar resistance training protocols in other catabolic conditions, that the resistance training will result in a significant increase in muscle quantity as well a physical function.

Detailed Description
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Muscle wasting is common in patients with chronic kidney disease and has been associated with decreased ability to complete activities of daily living, increased hospitalisation and therefore and decreased quality of life. In other catabolic conditions, such as cancer or rheumatoid arthritis, exercise is an established treatment to reverse muscle wasting. It is uncertain whether exercise has this effect in the chronic kidney disease population due to an altered hormone system that may prevent the anabolic effects of exercise from occurring. However, progressive resistance training, which is exercise that is most effective at eliciting an anabolic response has not been effectively carried out with haemodialysis patients. Therefore, this study aims to investigate whether or not a twelve week intradialytic progressive resistance training programme will have an effect on muscle quantity, physical function and quality of life in patients receiving maintenance haemodialysis.

Official Title
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Effects of Progressive Resistance Training During Haemodialysis on Muscle Quantity and Function in Patients With Chronic Kidney Disease

Conditions
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Chronic Kidney Disease

Intervention / Treatment
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* Other: Progressive resistance training programme
* Other: Sham exercise
* Other: Progressive resistance training
* Other: Sham exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic kidney diseases stage five requiring maintenance hemodialysis. Exclusion Criteria: Patients who have been receiving dialysis for less than 3 months; Are under the age of 18years; Have medical contradictions to participate in the exercise programs; Any uncontrolled medical condition which does not allow participation in exercise; Have known neuro-muscular disorders; Have any other uncontrolled medical condition, including pregnancy; Are not independently ambulant for 50 m; Have received anabolic intervention, or had catabolic conditions within the last 3 months; Have a cardiac pacemaker or other unsuitable implanted device for magnetic resonance; Are vulnerable to heat stress; Or are unable to give consent.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Chronic kidney disease progressive resistance training group<br>Progressive resistance training programme using a dialysis specific fitness machine: 80 % of predicted one repetition max, weight lifted will be increased when three sets of ten repetitions can be completed without failure. | Other: Progressive resistance training programme<br>* Progressive resistance training programme using a dialysis specific fitness machine: 80 % of predicted one repetition max, weight lifted will be increased when three sets of ten repetitions can be completed without failure.<br>* Other names: Intradialytic resistance exercise;|
| Sham Comparator: Chronic kidney disease sham exercise group<br>Lower body stretching exercise using the easiest rehabilitation elastic Theraband | Other: Sham exercise<br>* Lower body stretching exercise using the easiest rehabilitation elastic Theraband<br>|
| Experimental: Healthy controls progressive resistance training group<br>Progressive resistance training programme using a dialysis specific fitness machine: 80 % of predicted one repetition max, weight lifted will be increased when three sets of ten repetitions can be completed without failure. | Other: Progressive resistance training<br>* Progressive resistance training programme using a dialysis specific fitness machine: 80 % of predicted one repetition max, weight lifted will be increased when three sets of ten repetitions can be completed without failure.<br>|
| Sham Comparator: Healthy controls sham exercise group<br>Lower body stretching exercise using the easiest rehabilitation elastic Theraband | Other: Sham exercise<br>* Lower body stretching exercise using the easiest rehabilitation elastic Theraband<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle Cross Sectional Area | Muscle cross sectional area (quadriceps group) taken at midpoint slice between superior aspect of femoral head and the femoral condyle. | Change from baseline in cross sectional area at 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle Strength | Bilateral knee extensor isometric strength. | Change from baseline in muscle strength at 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Progressive Resistance Training/Exercise, Muscle wasting, Chronic Kidney Disease