Types and Benefits of Intradialytic Exercise: A Narrative Review

透析中運動的種類和益處：一個敘述性文獻回顧

Li-Fang Hu(胡莉芳) ； Ping-Chen Wang(王品溱) ； Yi-Ling Chen(陳依伶) ； Rong-Na Jhen(甄容納) ； Yu-Ming Chang(張祐銘) ； Jsun-Liang Kao(高尊良) ； Chih-Chung Shiao(蕭志忠)

《內科學誌》 36卷1期 (2025/02) Pp. 21-32

https://doi.org/10.6314/JIMT.202502_36(1).04

摘要

This narrative review explores the types and benefits of intradialytic exercise (IDE) for patients undergoing hemodialysis (HD). IDE, which includes physical activities performed during HD sessions, aims to improve patients' strength, endurance, and overall health. The review highlights various forms of IDE, such as intradialytic aerobic exercise (IAE), intradialytic resistance exercise (IRE), stretching exercises, blood flow restriction exercise (BFRE), intradialytic inspiratory muscle training (IIMT), and intradialytic neuromuscular electrical stimulation (INES). IAE is noted for its accessibility and effectiveness in enhancing physical functions, reducing fatigue, and improving health-related quality of life (HRQoL). IRE is particularly beneficial for increasing muscle strength and mass. Stretching exercises help mitigate muscle cramps and restless legs syndrome. Although BFRE and combined exercise programs show promise, further research is necessary to consolidate their benefits. The review also addresses the safety, feasibility, and adherence of IDE, noting that IDE is safer and has higher adherence rates compared to exercises performed outside HD clinics, due to supervision by medical staff and regular scheduling. However, IDE faces challenges such as limited space, equipment, scheduling conflicts, and patient motivation. Despite these barriers, IDE is a potential intervention for improving the health outcomes of HD patients, advocating for its integration into routine HD care to optimize patient prognoses and enhance the standard of care.

關鍵字

aerobic exercise ； end-stage kidney disease ； hemodialysis ； intradialytic exercise ； resistance exercise ； outcome

並列摘要

本敘述性文獻回顧探討了透析中運動（intradialytic exercise）的類型和對接受血液透析（HD）患者的臨床益處。透析中運動包括在血液透析過程中進行的體力活動，旨在改善患者的力量、耐力和整體健康。回顧強調了各種形式的透析中運動，例如透析中有氧運動（intradialytic aerobic exercise）、透析中阻力運動（intradialytic resistance exercise）、伸展運動、血流限制運動（BFRE）、透析中吸氣肌訓練（intradialytic inspiratory muscle training）和透析中神經肌肉電刺激（intradialytic neuromuscular electrical stimulation）。透析中有氧運動因其可及性和在增強身體功能、減少疲勞和改善與健康相關的生活品質（health-related quality of life）方面的有效性而備受關注。透析中阻力運動對增加肌肉力量和質量特別有益。伸展運動有助於減輕肌肉痙攣和不寧腿症候群。儘管血流限制運動和組合運動計劃顯示出潛力，但需要進一步的研究來確定其益處。回顧還討論了透析中運動的安全性、可行性和依從性，指出由於醫療人員的監督和定期安排，透析中運動比在血液透析診所外進行的運動更安全且依從率更高。然而，透析中運動面臨空間有限、設備不足、時間安排衝突和患者動機不足等挑戰。儘管存在這些障礙，透析中運動是一種潛在的干預措施，可改善血液透析患者的健康結果，倡導將其納入常規血液透析護理，以優化患者的預後並提高護理標準。