Echocardiographic changes after intradialytic resisted exercise in regular hemodialysis patients / Eman Mohamed Mahmoud Abdelhalim ; Supervised Aziz Guirguis Aziz , Essam Baligh , Sahier Omar Alkhashab

Thesis (Ph.D.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Cardiopulmonary and Geriatrics Disorders

The aim of this study was to investigate the effect of intradialytic resisted exercises on cardiovascular functions assessed by echocardiography and ambulatory blood pressure in patients on regular hemodialysis (HD). Forty patients of both genders on regular HD from Al Kasr Al Aini Hospital (Nephrology and Dialysis center), participated in this study. Patients were divided into two equal and matched groups: intervention group who received a program of intradialytic resisted exercises three times per week for 12 weeks, and control group who received the usual HD sessions only. The cardiovascular functions were measured using echocardiography and ambulatory blood pressure (ABP) for all the patients at the beginning of the study and after three months. The results of the current study demonstrated that intradialytic resisted exercises for 12 weeks resulted in significant (p< 0.05) drop in mean systolic blood pressure (MSBP) (mean decrease 3.96%), mean diastolic blood pressure (MDBP) (mean decrease 2.38%) and mean pulse pressure (mean decrease 6.43% %) in the intervention group. Moreover, there was significant (p<0.05) drop in mean left ventricle end diastolic diameter (LVEDD), left ventricle end systolic diameter (LVESD), left ventricle end diastolic volume (LVED volume), left ventricle end systolic volume (LVES volume), septal wall thickness(SWT), left ventricle mass (LVM) and left ventricle mass index (LVMI) ( mean decrease 4.85%, 6.40%, 10.24%, 22.29%, 2.73%, 14.57% and 15.30% respectively) in the intervention group. Finally intradialytic resisted exercises resulted in significant (p< 0.05) improvement of left ventricle systolic functions (left ventricle ejection fraction (LVEF) (mean increase 12.28%) in the intervention group. On the other hand the same parameters remained unchanged or worsened in the control group. It was concluded that intradialytic resisted exercises three times per week for 12 weeks in patients on regular HD had a positive effect on some cardiac functions in the form of reduction of left ventricle size and improvement of left ventricle systolic functions as measured by echocardiography. Moreover, intradialytic resisted exercises resulted in improvement of ambulatory blood pressure parameters such as MSBP, MDBP and pulse pressure in those patients

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