Randomized Controlled Trial of Walking Training with and Without Blood Flow Restriction in Patients Treated with Maintenance Hemodialysis

Abstract

nd walking training (WT) versus usual care controls on walking capacity among hemodialysis patients. Methods Patients treated with maintenance hemodialysis were recruited from two dialysis units in Suzhou, China between February to June 2024, and were randomly allocated into three groups using block randomization. The control group received usual care. The WT group received eight weeks of low-to-moderate intensity walking intervention. The WT-BFR group received the same intervention as the WT group, with the addition of 40% to 50% limb occlusion pressure applied during walking sessions. Walking capacity (primary outcome), physical function, health-related quality of life, anxiety, and depression were assessed at baseline, eight weeks, and 16 weeks. Results Fifty-seven eligible patients with a mean age of 54 years (Standard Deviation=10) were recruited. They were randomly allocated equally into the control group (N=19), WT-BFR group (N=19), and WT group (N=19). From baseline to eight weeks, the improvements in walking capacity were greater in the WT-BFR (mean differences and 95% confidence interval: 48.48, 28.81 to 68.16 meters) and WT (31.70, 9.29 to 54.11 meters) groups compared to the control group. At 16 weeks, the WT-BFR group also demonstrated a greater improvement in walking capacity than the WT group (34.63, 8.90 to 60.36 meters). Similarly, the WT-BFR and WT groups showed greater improvements in physical function and disease-specific domains of health-related quality of life, compared to the control group. Conclusions After an eight-week intervention, both WT-BFR and WT improved walking capacity, physical function, and health-related quality of life in maintenance hemodialysis patients. However, the prolonged benefits of WT-BFR in the hemodialysis population require further investigation. Copyright © 2025 by the American Society of Nephrology...