The Effects Of Eccentric Exercise In Elderly Patients With Chronic Kidney Diseases

PURPOSE: Previous studies have shown that aerobic and resistance exercise benefits Chronic Kidney Diseases (CKD) patients. Recent studies have shown that eccentric cycling has more advantages over concentric cycling. The purpose of this study is to investigate the effects of eccentric cycling training on cardiopulmonary fitness, and quality of life in patients with CKD. METHODS: Patients over 55 years old and confirmed CKD from the outpatient clinic at National Cheng Kung University Hospital were recruited. The inclusion criteria are GFR < 60 ml/min/1.73 m2 or receiving routine dialysis, communicate normally and walking independently. The participants were assigned into three groups using randomization design (eccentric cycling training (ECCcyc); concentric cycling training (CONcyc), and health education (control group)) for 8 weeks training. The exercise capacity was measured by cardiopulmonary exercise testing (CPET). SF-36 was used to understand the quality of life after exercise training. RESULTS: A total of 16 patients were allocated to 3 groups (ECCcyc: 6, CONcyc: 4, control: 6). VO2 at AT improved in the ECCcyc group (6.3 to 7.04 ml/kg/min [increase 11.7%]) compared with the CONcyc group (6.8 to 6.38 ml/kg/min [decrease 6.1%]) and the control group (8.88 to 7.35 ml/kg/min [decrease 17.2%]) (P < 0.001 between in three groups for the group by time interaction). VE/VO2 at AT improved in the ECCcyc group (50.67 to 33.2 [decrease 34.4%]) compared with the CONcyc group (36.25 to 39.75 [increase 9.6%]) and the control group (36.83 to 36[decrease 2.2%]) (P < 0.05 between in the ECCcyc and the CONcyc for the group by time interaction). In the results of SF-36, Physical functioning in the CONcyc group (52.5 to 57.5 [increase 9.5%]) compared with the ECCcyc group (80 to 79 [decrease 1.2%]) and the control group (80.83 to 69.17 [decrease 14.4%]) (P < 0.001 between in three groups for the group by time interaction). CONCLUSIONS: This study indicated that eccentric cycle exercise training is safe and effective and has greater improvement in VO2 at AT and VE/VO2 at AT than CON cycle exercise training. Thus, eccentric cycle exercise training may be appropriate for frail patients like CKD patients.