Dataset Information

Twelve weeks of combined physical and cognitive intradialytic training preserves alertness and improves gait speed: a randomized controlled trial.

ABSTRACT:

Background

Hemodialysis (HD) patients often experience cognitive deficits and reduced mobility. While studies have shown promising results of physical and/or cognitive training in older adults, their effects in HD patients remain understudied.

Aims

This study aimed to evaluate the impact of a 12-week intradialytic training program combining cognitive training with physical exercise on attention domains and spontaneous gait speed (SGS) in HD patients.

Methods

Forty-four HD patients were randomly assigned to either intradialytic cognitive and physical exercise training (EXP group; n = 22) or a standard care control group (CON group; n = 22). The EXP group performed intradialytic cycling and tablet-based cognitive training three days per week for 12 weeks. The primary outcome of the study was performance on the computerized test battery 'Test of Attentional Performance.' Secondary study outcome was patient mobility assessed by the four-meter SGS. Outcomes were assessed pre- and post-intervention.

Results

Significant group x time interaction was observed in alertness (F(1,41) = 6.15, p = 0.017) and SGS (F(1,41) = 18.33, p < 0.001) in favor of the EXP group. Within-group analysis revealed a significant pre-post decline in the CON group in alertness test (-26.7 s; p = 0.04) and an improvement of SGS in EXP group (+ 0.07 s; p < 0.001).

Discussion

This original study demonstrated that a combined physical and cognitive intradialytic training intervention led to improvements in SGS and preservation in alertness compared to a deterioration in the CON group.

Conclusion

Findings suggest that the intervention may serve as an effective tool to prevent the physical and cognitive decline in this patient population.

SUBMITTER: Bogataj S

PROVIDER: S-EPMC10520202 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Twelve weeks of combined physical and cognitive intradialytic training preserves alertness and improves gait speed: a randomized controlled trial.

Bogataj Špela Š Pajek Maja M Mesarič Katja Kurnik KK Kren Aljaž A Pajek Jernej J

Aging clinical and experimental research 20230726 10

<h4>Background</h4>Hemodialysis (HD) patients often experience cognitive deficits and reduced mobility. While studies have shown promising results of physical and/or cognitive training in older adults, their effects in HD patients remain understudied.<h4>Aims</h4>This study aimed to evaluate the impact of a 12-week intradialytic training program combining cognitive training with physical exercise on attention domains and spontaneous gait speed (SGS) in HD patients.<h4>Methods</h4>Forty-four HD p ...[more]

PMID: 37493889

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Project description:Gait speed is a measure of general fitness. Changing from usual (UGS) to maximum (MGS) gait speed requires coordinated action of many body systems. Gait speed reserve (GSR) is defined as MGS-UGS. From a shortlist of 88 features across five categories including sociodemographic, cognitive, and physiological, we aimed to find and compare the sets of predictors that best describe UGS, MGS, and GSR. For this, we leveraged data from 3,925 adults aged 50+ from Wave 3 of The Irish Longitudinal Study on Ageing (TILDA). Features were selected by a histogram gradient boosting regression-based stepwise feature selection pipeline. Each model's feature importance and input-output relationships were explored using TreeExplainer from the Shapely Additive Explanations explainable machine learning package. The mean Radj2 (SD) from fivefold cross-validation on training data and the Radj2 score on test data were 0.38 (0.04) and 0.41 for UGS, 0.45 (0.04) and 0.46 for MGS, and 0.19 (0.02) and 0.21 for GSR. Each model selected features across all categories. Features common to all models were age, grip strength, chair stands time, mean motor reaction time, and height. Exclusive to UGS and MGS were educational attainment, fear of falling, Montreal cognitive assessment errors, and orthostatic intolerance. Exclusive to MGS and GSR were body mass index (BMI), and number of medications. No features were selected exclusively for UGS and GSR. Features unique to UGS were resting-state pulse interval, Center for Epidemiologic Studies Depression Scale (CESD) depression, sit-to-stand difference in diastolic blood pressure, and left visual acuity. Unique to MGS were standard deviation in sustained attention to response task times, resting-state heart rate, smoking status, total heartbeat power during paced breathing, and visual acuity. Unique to GSR were accuracy proportion in a sound-induced flash illusion test, Mini-mental State Examination errors, and number of cardiovascular conditions. No interactions were present in the GSR model. The four features that overall gave the most impactful interactions in the UGS and MGS models were age, chair stands time, grip strength, and BMI. These findings may help provide new insights into the multisystem predictors of gait speed and gait speed reserve in older adults and support a network physiology approach to their study.

Dataset Information

Twelve weeks of combined physical and cognitive intradialytic training preserves alertness and improves gait speed: a randomized controlled trial.

Background

Aims

Methods

Results

Discussion

Conclusion

Publications

Twelve weeks of combined physical and cognitive intradialytic training preserves alertness and improves gait speed: a randomized controlled trial.

Similar Datasets

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