The benifits of exercise to those on dialysis

by Bill Peckham

Shad, announcing next year's What Inspires You Tour (I'm sure we'll be hearing more) comments on a post by Peter back in August. Peter was applauding Shad's efforts and pointing to published literature that supported Shad's message of greatly improved health through vigorous and ongoing exercise. Zach seconded Shad pointing to his own success living with CKD5 - Zach I believe likes the gym and has combined working out with dialysis for 26 years of CKD successful living. Exercise is a key part of living with chronic kidney disease.

It's all true. In the July issue of Hemodialysis International (link via HDCN) Dr. Kirsten L. Johanson "reviews the evidence of what the benefits are, what are the best types to recommend, and the new recs from the American College of Sports Medicine and the AHA for older individuals and for those with chronic diseases". This review looks at dozens of studies:

There is an ever-expanding body of literature related to the effects of exercise among patients with ESRD, and recently the quality of studies is improving. End-stage renal disease-specific data clearly suggest that exercise can improve many indicators of physical functioning such as fitness, muscle mass, physical performance, and self-reported physical functioning. Fewer data are available to address cardiovascular indices. However, preliminary evidence suggests that exercise can enhance the management of hypertension, reduce inflammation, and improve endothelial function.

Aerobic coupled with strength training seems to do the most good but there is evidence to suggest that basically any additional movement helps. The more the better. Peter's phrase "vigorous and ongoing" sums it up nicely.

Johansen commends the American College of Sports Medicine and the American Heart Association recently developed and published guidelines. Particularly the separate set of recommendations for individuals over 64 or individuals aged 50– 64 with ‘‘clinically significant chronic conditions or functional limitations that affect movement ability, fitness, or physical activity’’ (PDF link).

As always, you must talk with your doctor before starting an exercise program but the evidence is that exercise is hugely beneficial. The ACSM & AHA has produced a set of peer reviewed recommendation, until something just for people on dialysis comes along these should be our guidance. Now it is up to the people on the sharp end of the needle to do the work.

Comments

[Ricky Heden]

Everybody is nowadays a bit concerned about their physical fitness that can help them stay disease free, feel more energetic & even live for longer. They are looking for more than old fashioned exercises. However regular physical exercises are evolving out as better alternatives that can bring effective solutions to many of our stress related problems including chronic health conditions, obesity & sleeplessness.

http://healthfreak2.wordpress.com/2009/10/08/some-common-benefits-of-regular-physical-exercise/

[Roberta Mikles]

And, what about the use of those foot pedals that can be used for exercise during dialysis. Do any units utilize these exercise equipment pieces? I remember asking about this five years ago after reading an article on same.
Roberta Mikles
Advocates4QualitySafeCare
www.qualitysafepatientcare.com

[Bill Peckham]

I see them in use every now and then. I know at least one person who uses one every treatment. My Understanding is that part of the benefit of using one during treatment is to get blood moving around and mixing within the blood compartment.

Blood, when the body is at rest, tends to circulate in one part of the body. Movement during dialysis can increase the efficiency of the treatments.

Hi There
A friend of mine just emailed me one of your articles from a while back. i read that one a few more.