Abstract
Background and Aims
Sarcopenia is a skeletal muscle disorder associated with adverse outcomes including falls, physical disability and mortality particularly in hemodialysis (HD) patients. Currently, progressive resistance training exercise has been shown a proven method to treat and prevent sarcopenia. Nevertheless, these findings are poorly investigated in HD patients since exercise programs are not widespread.
The aim of our study was to assess the effect of a home-based resistance exercise program (HBREP) on muscular strength, functional capacity and body composition in our hemodialysis patients with sarcopenia according to the European Working Group on Sarcopenia in Older People criteria (EWGSOP2).
Method
A 12 weeks single-center prospective study. HD patients from our institution with EWGSOP2 sarcopenia diagnosis were enrolled in a HBREP. Demographical an anthropometrical data, main biochemical and nutritional parameters, hand grip (HG) muscular strength, functional capacity tests: Sit to stand to seat 5 (STS5); Short Physical Performance Battery (SPPB), gait speed (GS), as well as body composition determined by electrical bioimpedance (BIA) and sarcopenia severity were analized.
Results
18 HD patients with sarcopenia (71.4% severe) were included (4 drop out).78.6% men. Mean age 74.7 years and 53.3 months on HD. The main etiologies of ESRD were the HBP (21.4%) and DM (14.3%). Globally, a significant improvement was observed at the end of the study in relation to muscular strength (HG 19.9±6.1 vs 22.2±7.1 kg, p 0.001) and functional capacity tests (STS5 21.9±10.3 vs 17.2±9.9 sec, p 0.001; SPPB (6.9±2.3 vs 9.1±2.5 score, p 0.001 and GS 0.8±0.1 vs 0.9±0.2 m/s, p 0.015). Likewise, higher total skeletal muscle mass (SMM, 14.3±2.8 vs 14.5±2.9 kg) and SMM index (SMM/height2, 5.5±0.7 vs 5.7±0.9 Kg/m2 ) were found at the end of the study, although these differences were not significant. Finally, 2 patients (14.8%) reverse the EWGSOP2 sarcopenia criteria and 3 (21.4%) enhanced their severe sarcopenia. No relevant changes regarding anthropometrical data, main biochemical and nutritional parameters or dialysis adequacy were observed at the end of the study.
Conclusion
A home-based resistance exercise program improves muscular strength, functional capacity and body composition in our sarcopenic hemodialysis patients. With our results, home-based resistance exercise programs should be considered a key point in the prevention and treatment of skeletal muscle mass reduction due to sarcopenia in these patients. Further studies are mandatory to confirm our encouraging results.
Comment on the original article entitled “Ethanol lock is effective on reducing the incidence of tunneled catheter-related bloodstream infections in hemodialysis patients: a systematic review and meta-analysis”
