Research progress of physical therapy techniques for maintenance hemodialysis patients_West China Medical Journal

Authors：

LI Guo ^1,2 , GAO Qiang ^1,2 ,  HE Chengqi ^1,2

1. Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Rehabilitation Key Laboratory of Sichuan Province, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

HE Chengqi, Email: hxkfhcq@126.com

Keywords：

Maintenance hemodialysis; Functional limitations; Kinesitherapy; Physical agents therapy

DOI：

10.7507/1002-0179.202006092

Video：

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Abstract Full text Figures/Tables Video References Cited by

Along with the illness progresses of maintenance hemodialysis (MHD) patients, their functional limitations such as decreased cardiopulmonary endurance, muscle loss, dysfunction of arteriovenous fistula, fatigue, and sleep disorders are increasingly prominent and urgently need to be resolved. Modern physiotherapy as a non-invasive and non-pharmacological therapy which can reduce the functional limitations of MHD patients, improves the patients’ exercise capacity and quality of life. Physical therapy techniques suitable for MHD patients include active and passive exercise therapy such as aerobic exercise, resistance exercise, breathing training, and muscle stretching, as well as physical agents therapy such as neuromuscular electrical stimulation, infrared, and low-frequency pulsed electromagnetic field. Choosing appropriate physical agents and exercise prescription can reduce the treatment risk and improve the efficacy.

Citation： LI Guo, GAO Qiang, HE Chengqi. Research progress of physical therapy techniques for maintenance hemodialysis patients. West China Medical Journal, 2020, 35(7): 766-770. doi: 10.7507/1002-0179.202006092 Copy

1.	Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol, 2012, 23(3): 533-544.
2.	Johansen KL, Chertow GM, Kutner NG, et al. Low level of self-reported physical activity in ambulatory patients new to dialysis. Kidney Int, 2010, 78(11): 1164-1170.
3.	Sutcliffe BK, Bennett PN, Mohebbi M. The deterioration in physical function of hemodialysis patients. Hemodial Int, 2018, 22(2): 245-253.
4.	陳玉華, 馬偉光. 終末期腎病維持性血液透析患者生活質量調查. 國際護理學雜志, 2015, 34(17): 2321-2324.
5.	Nussbaum J, Garcia R. 物理療法對血液透析患者的運動能力影響: 促進腎臟病康復計劃研究的初步結果//中國康復研究中心. 第六屆北京國際康復論壇—內科康復分論壇論文集. 北京:《中國康復理論與實踐》編輯部, 2011: 32-33.
6.	Bae YH, Lee SM, Jo JI. Aerobic training during hemodialysis improves body composition, muscle function, physical performance, and quality of life in chronic kidney disease patients. J Phys Ther Sci, 2015, 27(5): 1445-1449.
7.	馬迎春. 我國腎康復的前景與挑戰. 現代實用醫學, 2017, 29(12): 1545-1547.
8.	Zhianfar L, Nadrian H, Asghari Jafarabadi M, et al. Effectiveness of a multifaceted educational intervention to enhance therapeutic regimen adherence and quality of life amongst Iranian hemodialysis patients: a randomized controlled trial (MEITRA Study). J Multidiscip Healthc, 2020, 13: 361-372.
9.	程艷嬌, 馬迎春. 解讀英國慢性腎臟病(CKD)患者運動康復的專家共識. 中國血液凈化, 2015, 14(8): 495-498.
10.	中國醫師協會康復醫師分會腎康復專業委員會, 馬迎春. 我國成人慢性腎臟病患者運動康復的專家共識. 中華腎臟病雜志, 2019, 35(7): 537-543.
11.	Painter P, Moore GE. The impact of recombinant human erythropoietin on exercise capacity in hemodialysis patients. Adv Ren Replace Ther, 1994, 1(1): 55-65.
12.	王欣欣, 宋桂蕓, 宿志梅, 等. 有氧運動對維持性血液透析患者生理功能、心肺耐力及生活質量的影響. 中國血液凈化, 2012, 11(9): 501-504.
13.	Guio BM, Gomes CP, Costa FBD, et al. Beneficial effects of intradialytic cardiopulmonary rehabilitation. J Bras Nefrol, 2017, 39(3): 275-282.
14.	Liu YM, Chung YC, Chang JS, et al. Effects of aerobic exercise during hemodialysis on physical functional performance and depression. Biol Res Nurs, 2015, 17(2): 214-221.
15.	Pu J, Jiang Z, Wu W, et al. Efficacy and safety of intradialytic exercise in haemodialysis patients: a systematic review and meta-analysis. BMJ Open, 2019, 9(1): e020633.
16.	Johansen KL. Exercise and chronic kidney disease: current recommendations. Sports Med, 2005, 35(6): 485-499.
17.	劉丹, 張紅梅, 范汝艷, 等. 維持性血液透析患者肌肉減少癥調查及影響因素分析. 中國中西醫結合腎病雜志, 2018, 19(4): 329-332.
18.	Cigarroa I, Barriga R, Michéas C, et al. Effects of a resistance training program in patients with chronic kidney disease on hemodialysis. Rev Med Chil, 2016, 144(7): 844-852.
19.	Lopes L, Prestes J, Lira FS. Intradialytic resistance training improves functional capacity and lean mass gain in individuals on hemodialysis: a randomized pilot trial. Arch Phys Med Rehabil, 2019, 100(11): 2151-2158.
20.	Marinho SM, Pelletier S, Carraro EJ. In hemodialysis patients, intradialytic resistance exercise improves osteoblast function:a pilot study. J Ren Nutr, 2016, 26(5): 341-345.
21.	Bessa B, de Oliveira Leal V, Moraes C, et al. Resistance training in hemodialysis patients: a review. Rehabil Nurs, 2015, 40(2): 111-126.
22.	Gomes Neto M, de Lacerda FFR, Lopes AA, et al. Intradialytic exercise training modalities on physical functioning and health-related quality of life in patients undergoing maintenance hemodialysis: systematic review and meta-analysis. Clin Rehabil, 2018, 32(9): 1189-1202.
23.	Frih B, Jaafar H, Mkacher W, et al. The effect of interdialytic combined resistance and aerobic exercise training on health related outcomes in chronic hemodialysis patients: the Tunisian randomized controlled study. Front Physiol, 2017, 8: 288.
24.	Abdelaal AAM, Abdulaziz EM. Effect of exercise therapy on physical performance and functional balance in patients on maintenance renal hemodialysis: randomized controlled study. J Exerc Rehabil, 2019, 15(3): 472-480.
25.	Cho JH, Lee JY, Lee S, et al. Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients. Int Urol Nephrol, 2018, 50(4): 745-754.
26.	徐月萍, 胡倩, 朱曉珍, 等. 抗阻訓練聯合有氧運動對維持性血液透析病人睡眠質量及疲乏狀況的影響. 護理研究, 2018, 32(2): 317-319.
27.	El-Deen HAB, Alanazi FS, Ahmed KT. Effects of inspiratory muscle training on pulmonary functions and muscle strength in sedentary hemodialysis patients. J Phys Ther Sci, 2018, 30(3): 424-427.
28.	Pellizzaro CO, Thomé FS, Veronese FV. Effect of peripheral and respiratory muscle training on the functional capacity of hemodialysis patients. Ren Fail, 2013, 35(2): 189-197.
29.	Aliasgharpour M, Abbasi Z, Pedram Razi S, et al. The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian J Sports Med, 2016, 7(2): e31001.
30.	葉白如, 李占園, 徐武敏. 穴位按摩對改善血液透析患者睡眠質量的臨床研究. 中華中醫藥學刊, 2014, 32(10): 2554-2555.
31.	Brüggemann AK, Mello CL, Dal Pont T, et al. Effects of neuromuscular electrical stimulation during hemodialysis on peripheral muscle strength and exercise capacity: a randomized clinical trial. Arch Phys Med Rehabil, 2017, 98(5): 822-831.e1.
32.	Miura M, Hirayama A, Oowada S, et al. Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial. Ren Replace Ther, 2018, 4(1): 1-8.
33.	Schardong J, Stein C, Della Méa Plentz R. Neuromuscular electrical stimulation in chronic kidney failure: a systematic review and meta-analysis. Arch Phys Med Rehabil, 2020, 101(4): 700-711.
34.	Martinez L, Esteve V, Yeste M, et al. Neuromuscular electrostimulation: a new therapeutic option to improve radio-cephalic arteriovenous fistula maturation in end-stage chronic kidney disease patients. Int Urol Nephrol, 2017, 49(9): 1645-1652.
35.	K?l?? Ak?a N, Ta?c? S. Acupressure and transcutaneous electrical acupoint stimulation for improving uremic pruritus: a randomized, controlled trial. Altern Ther Health Med, 2016, 22(3): 18-24.
36.	Yang LY, Chen HM, Su YC, et al. The effect of transcutaneous electrical nerve stimulation on increasing salivary flow rate in hemodialysis patients. Oral Dis, 2019, 25(1): 133-141.
37.	E?lence R, Karata? N, Ta?ci S. The effect of acupressure on the level of fatigue in hemodialysis patients. Altern Ther Health Med, 2013, 19(6): 23-31.
38.	吳愛純, 王小云, 何達. 超短波聯合認知行為干預對尿毒癥不安腿綜合征的療效. 中國康復, 2016, 31(1): 57-59.
39.	嚴賀, 李巧玲, 童輝, 等. 遠紅外線理療對血液透析病人動靜脈內瘺的保護作用. 護理研究, 2013, 27(4): 354-356.
40.	Mohammadi MM, Raygani AAV, Ghobadi A, et al. Effect of near-infrared light therapy based on acupoints on the severity of restless legs syndrome in patients undergoing hemodialysis: a single-blind, randomized controlled trial. Clin Med Res, 2018, 16(1/2): 1-8.
41.	Chen YW, Liu WS, Chou YH, et al. Far infrared therapy as a novel treatment for hand ischemia following arteriovenous graft for hemodialysis. EJVES Short Reports, 2015, 28: 30-33.
42.	Jirásková M, Jirásek L, Stork J. Therapy of pruritus using ultraviolet irradiation in patients on hemodialysis. Cas Lek Cesk, 2001, 140(6): 173-177.
43.	Swarna SS, Aziz K, Zubair T, et al. Pruritus associated with chronic kidney disease: a comprehensive literature review. Cureus, 2019, 11(7): e5256.
44.	Ala-Houhala MJ, V?h?vihu K, Hasan T, et al. Narrow-band ultraviolet B exposure increases serum vitamin D levels in haemodialysis patients. Nephrol Dial Transplant, 2012, 27(6): 2435-2440.
45.	Zhu S, He H, Zhang C, et al. Effects of pulsed electromagnetic fields on postmenopausal osteoporosis. Bioelectromagnetics, 2017, 38(6): 406-424.
46.	Rakocevichrnjak A, Vuksanovic M, Dimkovic N, et al. The effects of extreme low frequency pulsed electromagnetic field on bone mineral density and incidence of fractures in patients with end stage renal disease on dialysis - three year follow up study. Vojnosanitetski Pregled, 2016, 75: 212.
47.	張琳, 黃波, 丁桃. 物理因子聯合喜遼妥治療動靜脈內瘺外滲臨床療效觀察. 昆明醫科大學學報, 2014, 35(10): 156-157, 167.
48.	高燕紅, 楊愛軍. 磁療對血液透析患者內瘺管周圍癥狀的改善. 實用護理雜志, 2003, 19(1): 8-9.
49.	崔希鳳, 冷寧, 崔希剛. 不同心功能狀態下血液透析患者血流動力學變化分析. 現代中西醫結合雜志, 2014, 23(4): 383-385.
50.	Jeong JH, Biruete A, Fernhall B, et al. Effects of acute intradialytic exercise on cardiovascular responses in hemodialysis patients. Hemodial Int, 2018, 22(4): 524-533.

1. Jain AK, Blake P, Cordy P, et al. Global trends in rates of peritoneal dialysis. J Am Soc Nephrol, 2012, 23(3): 533-544.
2. Johansen KL, Chertow GM, Kutner NG, et al. Low level of self-reported physical activity in ambulatory patients new to dialysis. Kidney Int, 2010, 78(11): 1164-1170.
3. Sutcliffe BK, Bennett PN, Mohebbi M. The deterioration in physical function of hemodialysis patients. Hemodial Int, 2018, 22(2): 245-253.
4. 陳玉華, 馬偉光. 終末期腎病維持性血液透析患者生活質量調查. 國際護理學雜志, 2015, 34(17): 2321-2324.
5. Nussbaum J, Garcia R. 物理療法對血液透析患者的運動能力影響: 促進腎臟病康復計劃研究的初步結果//中國康復研究中心. 第六屆北京國際康復論壇—內科康復分論壇論文集. 北京:《中國康復理論與實踐》編輯部, 2011: 32-33.
6. Bae YH, Lee SM, Jo JI. Aerobic training during hemodialysis improves body composition, muscle function, physical performance, and quality of life in chronic kidney disease patients. J Phys Ther Sci, 2015, 27(5): 1445-1449.
7. 馬迎春. 我國腎康復的前景與挑戰. 現代實用醫學, 2017, 29(12): 1545-1547.
8. Zhianfar L, Nadrian H, Asghari Jafarabadi M, et al. Effectiveness of a multifaceted educational intervention to enhance therapeutic regimen adherence and quality of life amongst Iranian hemodialysis patients: a randomized controlled trial (MEITRA Study). J Multidiscip Healthc, 2020, 13: 361-372.
9. 程艷嬌, 馬迎春. 解讀英國慢性腎臟病(CKD)患者運動康復的專家共識. 中國血液凈化, 2015, 14(8): 495-498.
10. 中國醫師協會康復醫師分會腎康復專業委員會, 馬迎春. 我國成人慢性腎臟病患者運動康復的專家共識. 中華腎臟病雜志, 2019, 35(7): 537-543.
11. Painter P, Moore GE. The impact of recombinant human erythropoietin on exercise capacity in hemodialysis patients. Adv Ren Replace Ther, 1994, 1(1): 55-65.
12. 王欣欣, 宋桂蕓, 宿志梅, 等. 有氧運動對維持性血液透析患者生理功能、心肺耐力及生活質量的影響. 中國血液凈化, 2012, 11(9): 501-504.
13. Guio BM, Gomes CP, Costa FBD, et al. Beneficial effects of intradialytic cardiopulmonary rehabilitation. J Bras Nefrol, 2017, 39(3): 275-282.
14. Liu YM, Chung YC, Chang JS, et al. Effects of aerobic exercise during hemodialysis on physical functional performance and depression. Biol Res Nurs, 2015, 17(2): 214-221.
15. Pu J, Jiang Z, Wu W, et al. Efficacy and safety of intradialytic exercise in haemodialysis patients: a systematic review and meta-analysis. BMJ Open, 2019, 9(1): e020633.
16. Johansen KL. Exercise and chronic kidney disease: current recommendations. Sports Med, 2005, 35(6): 485-499.
17. 劉丹, 張紅梅, 范汝艷, 等. 維持性血液透析患者肌肉減少癥調查及影響因素分析. 中國中西醫結合腎病雜志, 2018, 19(4): 329-332.
18. Cigarroa I, Barriga R, Michéas C, et al. Effects of a resistance training program in patients with chronic kidney disease on hemodialysis. Rev Med Chil, 2016, 144(7): 844-852.
19. Lopes L, Prestes J, Lira FS. Intradialytic resistance training improves functional capacity and lean mass gain in individuals on hemodialysis: a randomized pilot trial. Arch Phys Med Rehabil, 2019, 100(11): 2151-2158.
20. Marinho SM, Pelletier S, Carraro EJ. In hemodialysis patients, intradialytic resistance exercise improves osteoblast function:a pilot study. J Ren Nutr, 2016, 26(5): 341-345.
21. Bessa B, de Oliveira Leal V, Moraes C, et al. Resistance training in hemodialysis patients: a review. Rehabil Nurs, 2015, 40(2): 111-126.
22. Gomes Neto M, de Lacerda FFR, Lopes AA, et al. Intradialytic exercise training modalities on physical functioning and health-related quality of life in patients undergoing maintenance hemodialysis: systematic review and meta-analysis. Clin Rehabil, 2018, 32(9): 1189-1202.
23. Frih B, Jaafar H, Mkacher W, et al. The effect of interdialytic combined resistance and aerobic exercise training on health related outcomes in chronic hemodialysis patients: the Tunisian randomized controlled study. Front Physiol, 2017, 8: 288.
24. Abdelaal AAM, Abdulaziz EM. Effect of exercise therapy on physical performance and functional balance in patients on maintenance renal hemodialysis: randomized controlled study. J Exerc Rehabil, 2019, 15(3): 472-480.
25. Cho JH, Lee JY, Lee S, et al. Effect of intradialytic exercise on daily physical activity and sleep quality in maintenance hemodialysis patients. Int Urol Nephrol, 2018, 50(4): 745-754.
26. 徐月萍, 胡倩, 朱曉珍, 等. 抗阻訓練聯合有氧運動對維持性血液透析病人睡眠質量及疲乏狀況的影響. 護理研究, 2018, 32(2): 317-319.
27. El-Deen HAB, Alanazi FS, Ahmed KT. Effects of inspiratory muscle training on pulmonary functions and muscle strength in sedentary hemodialysis patients. J Phys Ther Sci, 2018, 30(3): 424-427.
28. Pellizzaro CO, Thomé FS, Veronese FV. Effect of peripheral and respiratory muscle training on the functional capacity of hemodialysis patients. Ren Fail, 2013, 35(2): 189-197.
29. Aliasgharpour M, Abbasi Z, Pedram Razi S, et al. The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian J Sports Med, 2016, 7(2): e31001.
30. 葉白如, 李占園, 徐武敏. 穴位按摩對改善血液透析患者睡眠質量的臨床研究. 中華中醫藥學刊, 2014, 32(10): 2554-2555.
31. Brüggemann AK, Mello CL, Dal Pont T, et al. Effects of neuromuscular electrical stimulation during hemodialysis on peripheral muscle strength and exercise capacity: a randomized clinical trial. Arch Phys Med Rehabil, 2017, 98(5): 822-831.e1.
32. Miura M, Hirayama A, Oowada S, et al. Effects of electrical stimulation on muscle power and biochemical markers during hemodialysis in elderly patients: a pilot randomized clinical trial. Ren Replace Ther, 2018, 4(1): 1-8.
33. Schardong J, Stein C, Della Méa Plentz R. Neuromuscular electrical stimulation in chronic kidney failure: a systematic review and meta-analysis. Arch Phys Med Rehabil, 2020, 101(4): 700-711.
34. Martinez L, Esteve V, Yeste M, et al. Neuromuscular electrostimulation: a new therapeutic option to improve radio-cephalic arteriovenous fistula maturation in end-stage chronic kidney disease patients. Int Urol Nephrol, 2017, 49(9): 1645-1652.
35. K?l?? Ak?a N, Ta?c? S. Acupressure and transcutaneous electrical acupoint stimulation for improving uremic pruritus: a randomized, controlled trial. Altern Ther Health Med, 2016, 22(3): 18-24.
36. Yang LY, Chen HM, Su YC, et al. The effect of transcutaneous electrical nerve stimulation on increasing salivary flow rate in hemodialysis patients. Oral Dis, 2019, 25(1): 133-141.
37. E?lence R, Karata? N, Ta?ci S. The effect of acupressure on the level of fatigue in hemodialysis patients. Altern Ther Health Med, 2013, 19(6): 23-31.
38. 吳愛純, 王小云, 何達. 超短波聯合認知行為干預對尿毒癥不安腿綜合征的療效. 中國康復, 2016, 31(1): 57-59.
39. 嚴賀, 李巧玲, 童輝, 等. 遠紅外線理療對血液透析病人動靜脈內瘺的保護作用. 護理研究, 2013, 27(4): 354-356.
40. Mohammadi MM, Raygani AAV, Ghobadi A, et al. Effect of near-infrared light therapy based on acupoints on the severity of restless legs syndrome in patients undergoing hemodialysis: a single-blind, randomized controlled trial. Clin Med Res, 2018, 16(1/2): 1-8.
41. Chen YW, Liu WS, Chou YH, et al. Far infrared therapy as a novel treatment for hand ischemia following arteriovenous graft for hemodialysis. EJVES Short Reports, 2015, 28: 30-33.
42. Jirásková M, Jirásek L, Stork J. Therapy of pruritus using ultraviolet irradiation in patients on hemodialysis. Cas Lek Cesk, 2001, 140(6): 173-177.
43. Swarna SS, Aziz K, Zubair T, et al. Pruritus associated with chronic kidney disease: a comprehensive literature review. Cureus, 2019, 11(7): e5256.
44. Ala-Houhala MJ, V?h?vihu K, Hasan T, et al. Narrow-band ultraviolet B exposure increases serum vitamin D levels in haemodialysis patients. Nephrol Dial Transplant, 2012, 27(6): 2435-2440.
45. Zhu S, He H, Zhang C, et al. Effects of pulsed electromagnetic fields on postmenopausal osteoporosis. Bioelectromagnetics, 2017, 38(6): 406-424.
46. Rakocevichrnjak A, Vuksanovic M, Dimkovic N, et al. The effects of extreme low frequency pulsed electromagnetic field on bone mineral density and incidence of fractures in patients with end stage renal disease on dialysis - three year follow up study. Vojnosanitetski Pregled, 2016, 75: 212.
47. 張琳, 黃波, 丁桃. 物理因子聯合喜遼妥治療動靜脈內瘺外滲臨床療效觀察. 昆明醫科大學學報, 2014, 35(10): 156-157, 167.
48. 高燕紅, 楊愛軍. 磁療對血液透析患者內瘺管周圍癥狀的改善. 實用護理雜志, 2003, 19(1): 8-9.
49. 崔希鳳, 冷寧, 崔希剛. 不同心功能狀態下血液透析患者血流動力學變化分析. 現代中西醫結合雜志, 2014, 23(4): 383-385.
50. Jeong JH, Biruete A, Fernhall B, et al. Effects of acute intradialytic exercise on cardiovascular responses in hemodialysis patients. Hemodial Int, 2018, 22(4): 524-533.

West China Medical Journal

Research progress of physical therapy techniques for maintenance hemodialysis patients

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