Physical Training Program to Improve Exercise Capacity of Children with Chronic Kidney Disease

Introduction

Children with Chronic Kidney Disease (CKD) were reported to have reduced exercise capacity, including muscle strength and aerobic fitness. This may reduce their functional ability. Physical training may help improve their exercise capacity.

Objectives

To study the efficacy of the physical training program in improving the exercise capacity of local children with CKD.

Methodology

A four-week exercise training program with two sessions each week was conveyed to local children with CKD. The training program consisted of education on proper exercising, cardiopulmonary training, muscle strengthening, and establishment of exercise habit. Inclusion criteria of subjects were (1) age 11 to 18, (2) medically stable for exercise, (3) volitional participation. Outcome measures were (1) muscle strength: right and left handgrip (HGR, HGL), shoulder abductors (ShA), elbow flexors (ElbF), hip flexors (HipF), knee extensors (KnE), knee flexors (KnF); and (2) aerobic fitness: distance walked in 6-minute-walk-test (6MWD) and Fitkids Treadmill Test Endurance Time (FTTET). All outcomes were measured at baseline (within four weeks pre-program) and after intervention (one week post-program). Non-parametric Wilcoxon Signed Ranks Test was used to assess pre- and post-program differences because of the small subject number (< 30).

Results & Outcome

Fifteen subjects, with age 13 to 18 (15.36±1.8), were recruited. Eleven of them (72.2%) completed the training program and evaluations. Muscle strength (HGR, HGL, ShA, KnF), and aerobic fitness (6MWD, FTTET) were significantly improved post-program. (1) Muscle strength: HGR improved from 30.5±20.3lbs to 49.07±17.6lbs (p=0.004), HGL from 24.82±20.53lbs to 46.52±16.46lbs (p=0.004), ShA from19.86±5.24lbs to 24.5±6.3lbs (p=0.013), KnF from 24.88±8.05lbs to 30.14±6.73lbs (p=0.016); (2) Aerobic fitness: 6MWD improved from 442.45±69.14m to 518.72±61.78m (p=0.003), FTTET from 7.55±2.86min to 9.84±1.8min (p=0.004). Conclusion: The exercise capacity of local children with CKD can be improved by a four-week program of physical training, especially in the aspect of aerobic fitness. The long-term effect of the program should be further investigated.