Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial

BackgroundOlder adults dialysis patients represent the frailest subgroup of the End Stage Renal Disease (ESRD) population and physical exercise program may mitigate the age-related decline in muscle mass and function.MethodsDialysis patients of the EXCITE trial aged >65years (n=115, active arm, n=53; control arm, n=62) were submitted in random order to a home based, low intensity physical exercise program. At baseline and 6months after exercise training 6-min walking distance (6MWD) and 5-time sit-to-stand test (5STS) were performed, and quality of life (QoL) was tested.ResultsThe training program improved both the 6MWD (6-months: 32786m versus baseline: 29474m; P<0.001) and the 5STS time (6-months: 19.8 +/- 5.6s versus baseline: 22.5 +/- 5.1s; P<0.001) in the exercise group whereas they did not change in the control group (P=0.98 and 0.25, respectively). The between-arms differences (6months-baseline) in the 6MWD (+34.0m, 95% CI: 14.4 to 53.5m) and in the 5STS time changes (-1.9s, 95% CI: -3.6 to -0.3s) were both statistically significant (P=0.001 and P=0.024, respectively). The cognitive function dimension of QoL significantly reduced in the control arm (P=0.04) while it remained unchanged in the active arm (P=0.78) (between groups difference P=0.05). No patient died during the trial and the training program was well tolerated.Conclusions p id=Par4 This secondary analysis of the EXCITE trial shows that a home-based, exercise program improves physical performance and is well tolerated in elderly ESRD patients.Trial registration p id= Par5 The trial was registered in ClinicalTrials.Gov (Clinicaltrials.gov identifier: NCT01255969) on December 8, 2010.