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.	陈玉华, 马伟光. 终末期肾病维持性血液透析患者生活质量调查. 国际护理学杂志, 2015, 34(17): 2321-2324.
5.	Nussbaum J, Garcia R. 物理疗法对血液透析患者的运动能力影响: 促进肾脏病康复计划研究的初步结果//中国康复研究中心. 第六届北京国际康复论坛—内科康复分论坛论文集. 北京:《中国康复理论与实践》编辑部, 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.	马迎春. 我国肾康复的前景与挑战. 现代实用医学, 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.	程艳娇, 马迎春. 解读英国慢性肾脏病(CKD)患者运动康复的专家共识. 中国血液净化, 2015, 14(8): 495-498.
10.	中国医师协会康复医师分会肾康复专业委员会, 马迎春. 我国成人慢性肾脏病患者运动康复的专家共识. 中华肾脏病杂志, 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, 宋桂芸, 宿志梅, 等. 有氧运动对维持性血液透析患者生理功能、心肺耐力及生活质量的影响. 中国血液净化, 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.	刘丹, 张红梅, 范汝艳, 等. 维持性血液透析患者肌肉减少症调查及影响因素分析. 中国中西医结合肾病杂志, 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, 朱晓珍, 等. 抗阻训练联合有氧运动对维持性血液透析病人睡眠质量及疲乏状况的影响. 护理研究, 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.	叶白如, 李占园, 徐武敏. 穴位按摩对改善血液透析患者睡眠质量的临床研究. 中华中医药学刊, 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.	Kılıç Akça N, Taşcı 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.	Eğlence R, Karataş N, Taşci S. The effect of acupressure on the level of fatigue in hemodialysis patients. Altern Ther Health Med, 2013, 19(6): 23-31.
38.	吴爱纯, 王小云, 何达. 超短波联合认知行为干预对尿毒症不安腿综合征的疗效. 中国康复, 2016, 31(1): 57-59.
39.	严贺, 李巧玲, 童辉, 等. 远红外线理疗对血液透析病人动静脉内瘘的保护作用. 护理研究, 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, Vähävihu 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.	张琳, 黄波, 丁桃. 物理因子联合喜辽妥治疗动静脉内瘘外渗临床疗效观察. 昆明医科大学学报, 2014, 35(10): 156-157, 167.
48.	高燕红, 杨爱军. 磁疗对血液透析患者内瘘管周围症状的改善. 实用护理杂志, 2003, 19(1): 8-9.
49.	崔希凤, 冷宁, 崔希刚. 不同心功能状态下血液透析患者血流动力学变化分析. 现代中西医结合杂志, 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. 陈玉华, 马伟光. 终末期肾病维持性血液透析患者生活质量调查. 国际护理学杂志, 2015, 34(17): 2321-2324.
5. Nussbaum J, Garcia R. 物理疗法对血液透析患者的运动能力影响: 促进肾脏病康复计划研究的初步结果//中国康复研究中心. 第六届北京国际康复论坛—内科康复分论坛论文集. 北京:《中国康复理论与实践》编辑部, 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. 马迎春. 我国肾康复的前景与挑战. 现代实用医学, 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. 程艳娇, 马迎春. 解读英国慢性肾脏病(CKD)患者运动康复的专家共识. 中国血液净化, 2015, 14(8): 495-498.
10. 中国医师协会康复医师分会肾康复专业委员会, 马迎春. 我国成人慢性肾脏病患者运动康复的专家共识. 中华肾脏病杂志, 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, 宋桂芸, 宿志梅, 等. 有氧运动对维持性血液透析患者生理功能、心肺耐力及生活质量的影响. 中国血液净化, 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. 刘丹, 张红梅, 范汝艳, 等. 维持性血液透析患者肌肉减少症调查及影响因素分析. 中国中西医结合肾病杂志, 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, 朱晓珍, 等. 抗阻训练联合有氧运动对维持性血液透析病人睡眠质量及疲乏状况的影响. 护理研究, 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. 叶白如, 李占园, 徐武敏. 穴位按摩对改善血液透析患者睡眠质量的临床研究. 中华中医药学刊, 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. Kılıç Akça N, Taşcı 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. Eğlence R, Karataş N, Taşci S. The effect of acupressure on the level of fatigue in hemodialysis patients. Altern Ther Health Med, 2013, 19(6): 23-31.
38. 吴爱纯, 王小云, 何达. 超短波联合认知行为干预对尿毒症不安腿综合征的疗效. 中国康复, 2016, 31(1): 57-59.
39. 严贺, 李巧玲, 童辉, 等. 远红外线理疗对血液透析病人动静脉内瘘的保护作用. 护理研究, 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, Vähävihu 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. 张琳, 黄波, 丁桃. 物理因子联合喜辽妥治疗动静脉内瘘外渗临床疗效观察. 昆明医科大学学报, 2014, 35(10): 156-157, 167.
48. 高燕红, 杨爱军. 磁疗对血液透析患者内瘘管周围症状的改善. 实用护理杂志, 2003, 19(1): 8-9.
49. 崔希凤, 冷宁, 崔希刚. 不同心功能状态下血液透析患者血流动力学变化分析. 现代中西医结合杂志, 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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