Long-term pulse wave velocity outcomes with aerobic and resistance training in kidney transplant recipients - A pilot randomised controlled trial.
O'Connor EM, Koufaki P, et al.PLoS ONE [Electronic Resource] 2017; 12(2): e0171063.
Aims
To examine the long-term pulse wave velocity (PWV) and peak oxygen uptake (VO2peak) outcomes following a 12 week supervised aerobic or resistance training intervention in kidney transplant recipients.
Interventions
Participants were randomised after baseline assessment to either 12 weeks of supervised aerobic training (AT), resistance training (RT) or usual care. The AT or RT interventions included twice-weekly supervised, and once-weekly home-based, individually tailored exercise training as well as a once a week, 30-minute, physiotherapist led patient education.
Participants
Participants were those from the Exercise in Renal Transplant (ExeRT) study cohort* aged ≥18 years, who had received a kidney transplant in the preceding 12 months.
Outcomes
The primary outcome measured was PWV. Secondary outcomes measured included cardiorespiratory fitness, anthropometric measures and resting blood pressure.
Follow-up
9 months
CET Conclusions
In this pilot study the authors have examined in renal transplant recipients a 12 week moderate intensity aerobic or resistance training programme and compared the outcome with the usual care in a third group. They have examined pulse wave velocity (PWV) and peak oxygen uptake (VO2 peak) before and at the end of 12 weeks, and they have re-examined these parameters again at 12 months after entry. Forty-two of 60 participants completed the nine month follow-up assessment and so the numbers were small but there was an improved PWV, just significant, between resistance training and normal care groups. There was also a significant difference in VO2 peak values comparing aerobic training with usual care. There were no significance differences in body weight or blood pressure between the three groups and there were no significant adverse events associated with the interventions. The authors are fully aware of the weakness of the study, namely small numbers and a considerable number of drop-outs but they do suggest that a motivational interviewing approach combined with appropriate transition to community training programmes might be able to maintain the improvements gained from the 12 week exercise interventions, and that further research in this area is therefore warranted. This is a balanced conclusion in my mind. Obviously exercise is important for kidney transplant recipients but the problem is in providing the motivation to continue with exercise programmes either supervised or unsupervised.
Data analysis
Modified intention-to-treat analysis
Quality notes
Previously assessed as *Greenwood SA,et al. Aerobic or Resistance Training and Pulse Wave Velocity in Kidney Transplant Recipients: A 12-Week Pilot Randomized Controlled Trial (the Exercise in Renal Transplant [ExeRT] Trial) Am J Kidney Dis 2015 Oct; 66(4):689-98.
Trial registration
ISRCTN - 43892586