Most patients with end-stage renal disease choose maintenance hemodialysis to prolong survival. The clinical application of exercise therapy has a definite effect on maintenance hemodialysis patients, and can effectively improve their quality of life and promote rehabilitation. Individualized exercise therapy under the guidance of medical professionals has positive effects on patients’ physical and mental rehabilitation. This paper mainly summarizes the status of exercise, factors affecting exercise, exercise therapy, exercise and rehabilitation of maintenance hemodialysis patients, and reviews the impact of exercise therapy on the physical and mental health of maintenance hemodialysis patients, in order to provide some references for clinical intervention and prognosis studies.
ObjectiveTo systematically review the efficacy of exercise interventions on thoracic kyphosis in adults. MethodsThe PubMed, EMbase, Web of Science, CINAHL, Cochrane Library, CNKI, CBM, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objective from inception to November 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.4 software. ResultsA total of 10 RCTs involving 482 patients were included. The results of meta-analysis showed that exercise interventions could reduce kyphosis angle (MD=−5.27, 95%CI −8.37 to −2.17, P<0.01) and improve quality of life (SMD=0.78, 95%CI 0.52 to 1.04, P<0.01) in thoracic kyphosis in adults, but there were no significant differences between the two groups in pain and physical function. ConclusionCurrent evidence suggests that exercise interventions can reduce thoracic kyphosis angle and improve quality of life in adults, but the effects on pain and physical function are unclear. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Chronic kidney diseases (CKD) with long duration and a variety of complications have caused great physical and psychological problems for patients, and the overall quality of life of patients is low. Taijiquan, as a traditional Chinese techniques project, is beneficial to improving cardiopulmonary function, enhancing lower limb muscle strength, and reducing cardiovascular and cerebrovascular risks. We summarized the latest progress in clinical research concerning taijiquan as exercise rehabilitation for patients with CKD, aiming to promote the clinical application of taijiquan and other traditional exercises in the rehabilitation process of CKD patients and improve the overall quality of life of CKD patients.
Elderly patients with chronic kidney disease not only suffer from senescence-related muscle strength decline, but also exist muscle attenuation caused by chronic kidney disease. Sarcopenia of this group are more obvious, and falls, incapacity, weakness and death caused by sarcopenia are more prominent. At present, clinicians’ understanding of sarcopenia is still in the aspects of concept popularization and basic research, and there is a lack of practical diagnosis and treatment process and clinical prevention and treatment practice. Starting from the evolution of the definition of sarcopenia, this paper elaborates on the characteristics of sarcopenia in elderly patients with chronic kidney disease, as well as the exercise rehabilitation of sarcopenia in elderly patients with chronic kidney disease, in order to improve the attention and understanding of renal colleagues on sarcopenia in elderly people with chronic kidney disease.
ObjectiveTo investigate the static pulmonary function and cardiopulmonary exercise function of convalescent patients with coronavirus disease 2019 (COVID-19) after discharge.MethodsPulmonary function and cardiopulmonary exercise capacity of COVID-19 patients who admitted to our hospital from January to March 2020 were analyzed. The patients were divided into a non-critical group (3 cases of moderate illness, 2 cases of severe illness) and a critical group (5 cases of critical illness). Five of the 10 patients completed spirometry on day 14 after discharge. All patients performed spirometry, diffusion capacity and cardiopulmonary exercise test around 28 days post-discharge. Ten healthy subjects were used as a control group.ResultsForced expiratory volume in one second of percent predicted (FEV1%pred), forced vital capacity of percent predicted (FVC%pred), the FEV1/FVC ratio (FEV1/FVC), peak expiratory flow of percent predicted (PEF%pred) and mean forced expiratory flow between 25% and 75% of percent predicted (FEF25%-75%%pred) of COVID-19 group were all within normal ranges, and there were no significant difference between COVID-19 group and the healthy group (P>0.05). Diffusion capacity (the carbon monoxide diffusion capacity of percent predicted, DLCO%pred) decreased in 3 patients. The peak oxygen uptake of percent predicted (PeakVO2%pred), oxygen uptake efficiency slope (OUES), Oxygen pulse of percent predicted (VO2/HR%pred) in COVID-19 group decreased and were statistically significantly lower than the control group (P<0.05), but there was no significant difference in ventilatory equivalents for carbon dioxide at anaerobic threshold (VE/VCO2@AT) and the slope of ventilatory equivalent for carbon dioxide (VE/VCO2 slope) between the two groups (P>0.05). Compared to the non-critical group, the critical group displayed significantly lower FVC%pred and VO2/HR%pred (P<0.05). A decrease in PeakVO2%pred was observed in critical group, but the difference did not reach statistical significance (P>0.05). The FVC%pred and PEF%pred were significantly improved in 5 COVID-19 convalescents on Day 28 after discharge when comparing with day 14 (P<0.05).ConclusionsIn the first month after discharge, recovered COVID-19 patients mainly presented decreased exercise endurance in cardiopulmonary function tests.There are also some survivors with reduced diffusion function, but the impaired lung function of COVID-19 patients might return over time.
Chronic obstructive pulmonary disease (COPD) is one of the major chronic diseases that seriously endanger the health of residents in our country. Exercise is one of the effective interventions to improve the cardiopulmonary function and quality of life of COPD patients. An exercise prescription specifies the frequency, intensity, duration, mode, total exercise volume, and progression of exercise, forming a clear - purpose and systematic exercise guidance plan. Clinical pathways standardize and proceduralize the patient's diagnosis and treatment process. Developing an exercise prescription for the entire process of issuing and implementing exercise prescriptions for COPD patients helps to promote the application of exercise prescriptions and assist in the implementation of related work in primary - level medical institutions. Therefore, we invited a number of COPD experts and sports medicine experts to develop this clinical pathway in combination with domestic and international guidelines, consensuses, and personal experience. Its aims are to simplify the exercise prescription development process, reduce the required level of expertise, enhance the capacity of primary healthcare institutions, and facilitate the application of exercise prescriptions within these settings.
In 2020, chronic kidney disease has become one of the top 10 causes of death in the world. More and more evidence shows that proper exercise rehabilitation is beneficial to the health of patients with chronic kidney disease, which can improve the survival rate and slow down the decline of renal function. However, existing studies have significant differences in form, intensity, duration, and specific implementation methods of sports rehabilitation, which need to be further standardized and unified. This article introduces the impact of exercise rehabilitation on patients with chronic kidney disease and the clinical application of Chinese traditional exercises in patients with chronic kidney disease, and mainly discusses the application experience of exercise rehabilitation characterized by “Three-in-one Taiji” in the Department of Nephrology of West China Hospital of Sichuan University. It aims to provide a basis for the model innovation of integrated management of chronic kidney disease in China.
Objective To review the up-to-date development of overseas cl inical study on exercise therapy for patients with knee osteoarthritis. Methods The cl inical researches of exercise therapy for knee osteoarthritis were summarized by reviewing l iterature concerned in recent years. Results Exercise therapy was extensively used in the treatment of knee osteoarthritis not only in hospital but also in community rehabil itation abroad. The main patterns of exercise therapy included muscle strengthening exercise, aerobic exercise and underwater exercise. It was capable of effectively improving patient’s independent l iving abil ity and l ive qual ity, and postproning the time of surgical intervention. But the long-term efficacy of exercise therapy was still under debate. Conclusion Exercise therapy is an effect method to treat knee osteoarthritis.
ObjectiveTo systematically review the clinical efficacy of exercise therapy for patients with low back pain. MethodsWe electronically searched databases including PubMed, The Cochrane Library, CNKI, WanFang Data and VIP from 2000 to September 2014 to collect randomized controlled trial (RCTs) about exercise therapy versus other therapies in the treatment of low back pain. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of five RCTs involving 413 patients were finally included. Compared with the control group, exercise therapy could relieve pain (MD=-0.92, 95%CI -1.32 to -0.51, P<0.000 1), and improve function activity (MD=-1.21, 95%CI -1.43 to -0.99, P<0.01). ConclusionExercise therapy can improve low back pain and functional activity to a certain extent. Due to the limited quantity and quality of the included studies, larger scale, multicenter, high quality RCTs are needed to verify the aforementioned conclusion.
Objective To investigate the change of N-terminal pro-B-type natriuretic peptide ( NT-proBNP) levels in plasma of patients with stable chronic obstructive pulmonary disease ( COPD) at exertion. Methods Pulmonary function testing, increamental and constant cycle ergometer exercise testing were performed in 19 patients with stable COPD and 10 healthy subjects. Arterial blood gas analysis were measured at rest and maximal exertion in incremental testing. Venous blood samples were drawn both at rest and maximal exercise in constant-load exercise testing and NT-proBNP levels were measured. Results NT-proBNP levels did not change significantly during exercise in the patients with stable COPD[ ( 4803. 86 ±1027. 07 ) ng/L vs ( 4572. 39 ±1243. 33 ) ng /L, P = 0. 542 ] and the control group [ ( 4303. 18 ±771. 74) ng/L vs ( 4475. 71 ±1025. 50) ng /L, P = 0. 676] . NT-proBNP levels were not correlated with parameters of cardiopulmonary exercise testing. Conclusion The factors other than cardiac function may contribute to the exercise intolerance in stable COPD patients without heart failure.