Moderate Versus Low Intensity Aerobic Exercise on Bone Mineral Density in Patients on Hemodialysis

Nesreen G. El-Nahas; Heba A. Bahey; Shimaa N.Aboelazm

Authors

Nesreen G. El-Nahas
Heba A. Bahey
Shimaa N.Aboelazm

Keywords:

bone mass density /osteoporosis/ renal haemodialysis/ aerobic exercises

Abstract

Chronic kidney disease (CKD) is recognized as a major health problem reflecting the growing elderly population and increasing numbers of patients with diabetes and hypertension. Medical researches confronted with mana- gement of complex medical problems that are unique to patie- nts with chronic renal impairment and renal dialysis where pati- ents suffer from hypocalcemia that subjected them to oste- oporosis. Objective: The aim of this study was to compare the effect of two different intensities of aerobic exercises on bone mass density in patients on haemodialysis Subjects: Thirty m-ale patients underwent renal haemodialysis for 2 years ago with mean age (52.75±4.51)were recruited from Police hos-pital . Methods: They were assigned randomly into two gro- ups, 15 patients in each group. Group (A) attended a program of moderate intensity aerobic treadmill exercise (60-70%MHR), where Group (B) attended a program of light intensity aerobic treadmill exercise (40-60%MHR), both for 6 months (3 sessions of exercise per week) prior to the dialysis session. Laboratory investigations for serum calcium and phosphorus level in addition to a dual X ray absorpimetry (DXA) were ap- plied at baseline and after 6 months of training for both gro- ups. Results: The study revealed a significant difference in bo-ne mineral density in favor of group A with P- value 0.01 as w-ell as a significant increase in serum calcium by 12.29 %, 4.23 % and significant decrease in serum phosphorus with 21.67 %, 6.52 % for group A and B respectively. Conclusion: Mod-erate intensity aerobic exercise is more effective than light inte-nsity aerobic exercise in modulating serum calcium and pho-sphorus and thus improving BMD in patients with hemod-ialysis.

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Moderate Versus Low Intensity Aerobic Exercise on Bone Mineral Density in Patients on Hemodialysis. (2013). Global Journal of Medical Research, 13(28), 11-18. https://medicalresearchjournal.org/index.php/GJMR/article/view/

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Author Biographies

Nesreen G. El-Nahas

Shimaa N. Aboelazm is a dedicated researcher and academic affiliated with Cairo University and Misr University for Science and Technology in Egypt. Based in the Department of Basic Sciences at the Faculty of Physical Therapy, Misr University for Sciences and Technology, her work focuses on physiotherapy and rehabilitation. She has contributed to studies such as 'Moderate Versus Low Intensity Aerobic Exercise on Bone Mineral Density in Patients on Hemodialysis' and 'Extra corporeal shock wave therapy is superior to ultrasound in the treatment of lateral epicondylitis: An experimental study.' With 9 publications, 23 citations, an h-index of 3, and an i10-index of 1, Dr. Aboelazm continues to advance knowledge in physical therapy and exercise science.

Shimaa N.Aboelazm

Shimaa N. Aboelazm is a dedicated researcher and academic affiliated with Cairo University and Misr University for Science and Technology in Egypt. Based in the Department of Basic Sciences at the Faculty of Physical Therapy, Misr University for Sciences and Technology, her work focuses on physiotherapy and rehabilitation. She has contributed to studies such as 'Moderate Versus Low Intensity Aerobic Exercise on Bone Mineral Density in Patients on Hemodialysis' and 'Extra corporeal shock wave therapy is superior to ultrasound in the treatment of lateral epicondylitis: An experimental study.' With 9 publications, 23 citations, an h-index of 3, and an i10-index of 1, Dr. Aboelazm continues to advance knowledge in physical therapy and exercise science.

References

U. (2006) Excerpts From the UNITED STATES RENAL DATA SYSTEM 2005 ANNUAL DATA REPORT: ATLAS OF END-STAGE RENAL DISEASE IN THE UNITED STATES.

V. Kumar (2009) Robbins and Cotran Pathologic Basis of Disease. 2.

A. Zittermann, O. Sabatschus, S. Jantzen, P. Platen, A. Danz, P. Stehle (2002) Evidence for an ac- ute rise of intestinal calcium absorption in resp-onse to aerobic exercise EurJNutr. 41(5), 189-196. https://doi.org/10.1007/s00394-002-0375-1

A. Fauci (2008) Harrison's Principles of Internal Medicine. 268, 1373, 1313.

Anthony Woolf, Kristina Akesson (2008) Book of An Atl- as of Investigation and Manegement.

A. Wluka, Y. Wang, S. Davis, F. Cicuttini (2005) Cicuttini, F.M.: Tibial plateau size is related to grade of joint space narrowing and osteophytes in healthy women and in women with osteoarthritis: Ann Rheum Dis. 64(7), 1033-1037. https://doi.org/10.1136/ard.2004.029082

Belinda Beck, Christine Snow (2003) Bone Health Across the Lifespan???Exercising Our Options. 31(3), 117-122. https://doi.org/10.1097/00003677-200307000-00003

Heiwe S, Clyne N, Tollback A, Borg K (2005) Effects of Regular Resistance Training on Muscle Histopathology and Morphometry in Elderly Patients With Chronic Kidney Disease. 84(11), 865-874.

Mcintyre CW, Selby NM, Sigrist M, Pearce LE, Mercer TH, Naish PF (2006) Patients receiving maintenance dialysis have more severe functionally significant skeletal muscle wasting than patients with dialysis-independent chronic kidney disease. 21(8), 2210-2216.

Cheema BS, Abas H, Smith B, O'Sullivan AJ, Chan M, Patwardhan A, Kelly J, Gillin A, Pang G, Lloyd B, Berger K, Baune BT, Fiatarone MA (2010) Effect of resistance training during hemodialysis on circulating cytokines: a randomized controlled trial.

Painter P, Moore G, Carlson L, Paul S, Myll J, Philips W, Haskell W (2002) Effects of exercise training plus normalization of hematocrit on exercise capacity and health-related quality of life. 39(2), 257-265. https://doi.org/10.1053/ajkd.2002.30544

DePaul V, Moreland J, Eager T, Clase CM (2002) The effectiveness of aerobic and muscle strength training in patients receiving hemodialysis and EPO: a randomized controlled trial. Am J Kidney Dis. 40(6), 1219-1229.

Pechter U, Ots M, Mesikepp S, Zilmer K, Kullissaar T, Vihalemm T (2003) Beneficial effects of wat-er-based exercise in patients with chronic kidney disease. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilit-ationsforschung. 26(2), 153-156.

G. Kosmadakis, A. Bevington, A. Smith, E. Clapp, J. Viana, N. Bishop, J. Feehally (2010) Physical Exercise in Patients with Severe Kidn-ey Disease Nephron Clin Pract; 115:c7-c16. 115(1), c7-c16.

D. Carter, M. Bouxsein, Marcus (1992) New approaches for interpreting projected bone densitometry data. 7, 137-145.

J. Yeh, J. Aloia (1990) Effect of physical activity on calciotropic hormones and calcium balance in rats. 258, E263-E268.

S. Yasumura (1989) Effect of physical activity on calcium and phosphorus metabolism in the rat. 256, E1-E6.

T. Huang, S. Lin, F. Chang, S. Hsieh, S. Liu, R. Yang (2003) Effects of different exercise modes on mineralization, structure, and biomechanical properties of growing bone. 95, 300-303.

K. Hart, J. Shaw, E. Vajda, M. Hegsted, S. Miller (2001) Swim-trained rats have greater bone mass, density, strength, and dynamics. 91(4), 1663-1668. https://doi.org/10.1152/jappl.2001.91.4.1663

Jo Welch, Connie Weaver (2005) Calcium and Exercise Affect the Growing Skeleton. 63(11), 361-373. https://doi.org/10.1301/nr.2005.nov.361-373

Indralingam Vaithilingam, Kevan Polkinghorne, Robert Atkins, Peter Kerr (2004) Time and exercise improve phosphate removal in hemodialysis patients. 43(1), 85-89. https://doi.org/10.1053/j.ajkd.2003.09.016

Wadi Suki (2008) Effects of Sevelamer and Calcium-Based Phosphate Binders on Mortality in Hemodialysis Patients: Results of a Randomized Clinical Trial. 18(1), 91-98. https://doi.org/10.1053/j.jrn.2007.10.019

John Stevenson, Michael Marsh (2007) An Atlas of Osteoporosis, third edition. https://doi.org/10.3109/9780203090848

N. Asadi, S. Bassampour, M. Zolfaghari (2007) Critical care nursing ICU, CCU, dialysis. 2, 448-453.

Ioannis Karamouzis, Dimitrios Grekas, Michael Karamouzis, Konstantinos Kallaras, Vassiliki Stergiou-Michailidou, Evangelia Kouidi, Asterios Deligiannis, Norma Vavatsi-Christaki (2009) Physical training in patients on hemodialysis has a beneficial effect on the levels of eicosanoid hormone-like substances. 8(2), 129-137.

Koukouvou Konstantinidou E, Deligiannis Kouidi E, Tourkantonis A (2002) Exercise training in patients with end-stage renal disease on hemodialysis: comparison of three rehabilitation progr- ams. 34, 40-45.

A. Deligiannis (2004) Cardiac adaptations following exercise training in hemodialysis patients. 61, 539-545.

Kouidi A, Albani M, Natsis K (1998) The effects of exercise training on muscle atrophy in haemodialysis patients. 13(3), 685-699. https://doi.org/10.1093/ndt/13.3.685

Hagberg JM, Zmuda JM, McCole SD, Rodgers KS, Ferrell RE, Wilund KR, Moore GE (2001) Moderate physical activity is associated with higher bone mineral density in postmenopausal women. J Am Geriatr Soc. 49(11), 1411-1417.

Kevin Vincent, Randy Braith (2002) Resistance exercise and bone turnover in elderly men and women. 34(1), 17-23. https://doi.org/10.1097/00005768-200201000-00004

Hurley FB, Stephen MR (2000) Strength Training in the Elderly. Effects on Risk Factors for Age-Related Diseases. 30(4), 249-268.

M. Gilbert, Amy HO, Helen CHUNG, LUK (2003) Role of Physiotherapy in Renal Rehabilitation. 8(2).

Cappy CS, Jablonka J, Schroeder ET (1999) The effects of exercise. 9, 63-70.

Department of Health and Human Services (1996) Surgeon General's Report on Physical Activity and Health.

Kirsten Johansen (2007) Exercise in the End-Stage Renal Disease Population. 18(6), 1845-1854. https://doi.org/10.1681/asn.2007010009

National Heart Foundation (2004) The Better Health Channel is part of the Department of Human Services, State of Victoria.

Ots M, Mesikepp S, Zilmer K, Kullissaar T, Vihalemm T (2003) Beneficial effects of water-based exercise in patients with chronic kidney disease. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung. 26(2), 153-156.