Exercise is an indispensable part of the routine treatment of chronic kidney disease. For many hemodialysis patients, anemia, malnutrition, bone and joint lesions, and cardiovascular disease limit their tolerance when exercising, and psychological factors make patients hesitant to try exercise easily. In fact, appropriate exercise can improve the health status of patients, enhance their confidence and improve their quality of life.
Exercise can delay the physiological changes caused by age and inactivity such as bone loss, aging of the heart and skeletal muscles, anemia and diabetes due to poor glucose tolerance. Exercise can reduce these risk factors to achieve the purpose of slowing down aging. Among them, regular and continuous aerobic exercise is the best way to exercise. Aerobic exercise can not only reduce blood triacylglycerol, correct hyperlipidemia, but also increase hemolysis activity, reduce the formation of blood clots and thus reduce the incidence of cardiovascular disease. At the same time, the increase in metabolism and sweating has the dual effect of weight loss and appetite promotion. It is worth mentioning that proper exercise can reduce the tension and anxiety of dialysis patients, eliminate the stress and anxiety of life, and thus improve self-confidence.
Therefore, as long as hemodialysis patients undergo proper physical assessment and adequate prior preparation, they do not have to choke and can still enjoy the fun of exercise.
First, hemodialysis patients should do the following before exercising.
1. Correct anemia: Anemia can lower exercise tolerance, make the heart muscle prone to ischemia and even heart rate disorders. Therefore, hemoglobin should be kept above 100 g/l as much as possible;
2, control blood pressure: If blood pressure is not well controlled, blood pressure will rise sharply during exercise, and the result may be myocardial infarction or stroke;
3, maintain blood potassium in the normal range: blood potassium concentration often rises during exercise and falls sharply after exercise. Large fluctuations in blood potassium levels often lead to heart instability and heart rate disorders. The blood potassium concentration in patients with hemodialysis is usually higher than that of the general population, and it is even higher when they are taking blood pressure drugs such as angiotensin-converting enzyme inhibitors and beta-blockers (e.g., betalactam). Therefore, it is necessary to maintain a normal electrolyte concentration in the body;
4. Maintain appropriate dry weight: Water retention in the body can be a burden on the heart and can also cause hypertension, and should be avoided.
5. Assessing heart function: Exercise is potentially dangerous and can aggravate pre-existing heart disease and cause cardiac hypertrophy. For those with coronary artery disease, hypertension and cardiomyopathy, excessive exercise may cause arrhythmias or even sudden death. Therefore, for these hemodialysis patients, electrocardiogram and cardiac ultrasound should be performed beforehand to evaluate the possibility of exercise.
Although hemodialysis patients can play basketball, volleyball and other ball games, and even engage in bodybuilding and marathon running abroad, as long as they are well prepared beforehand. However, the most suitable exercise for patients is preferably some isotonic exercise with less load on their muscles and bones, and we do not advocate too strenuous exercise for hemodialysis patients. Patients can go for a walk, play Tai Chi, do radio gymnastics, or jog in the morning and evening. For example, if you think you can walk 200 meters, walk 100 meters first, and then gradually increase the amount of exercise in a gradual manner. Stable and consistent exercise is the most important principle of fitness for hemodialysis patients. Exercise can produce effects other than diet control, medication and liquid dialysis, and can improve patients’ lifestyles and enable them to completely dissolve into normal society, which is worth advocating and promoting.
Second, hemodialysis patients do exercise to pay attention to matters.
1, choose the appropriate weather for exercise, the weather is too hot or too cold, should not exercise;
2, to exercise when you feel good, if you have a fever and cold, two days after a complete recovery before exercising;
3, do not do exercise when fasting, two hours after meals and then exercise;
4, hemodialysis patients exercise, it is best to be accompanied by someone, exercise should wear loose, comfortable, breathable clothes, wear sports shoes;
Third, how to determine the appropriate amount of exercise?
1.Pulse and blood pressure should be measured and recorded before and after exercise;
2, step by step, gradually adapt;
3, pay attention to self-perception, if there is discomfort, immediately terminate;
4, there will be a change in the depth and frequency of breathing, but no conversation difficulties, recovery time is usually no more than 5 minutes;
5, such as shortness of breath during exercise can not talk, weakness or obvious joint pain or stiffness after exercise, suggesting that the amount of exercise may be too much;
6, the subjective feeling of the appropriate amount of exercise: slight sweating during exercise, slight fatigue, a slight shortness of breath, but does not affect the conversation;
7, the general movement stopped 6 minutes after the pulse rate per minute should be less than 100 to 110 times, the next morning, it can return to the usual level or slightly slowed down.
Fourth, choose the appropriate way to exercise
The way of training in life
Specific training methods
1.Walking
Walk for 2-3 minutes each time, with an average of 60-80 steps per minute, alternately, for a total of 20-30 minutes, in order not to have palpitations, wheezing and lower limb weakness. Then gradually extend the walking time and shorten the rest time according to your condition
2.Up and down steps training
Use stairs and steps to exercise. At the beginning, you can hold the handle of the stairs or with the help of others, up and down a step, two steps, and properly extend the exercise time, increase the height of the steps, from 5 minutes each time to 10 minutes, and gradually transition to complete the above exercise independently
3.Gymnastics
Forward bending, side movement, rotation movement, body forward bending, each action repeated 5-10 times
4.Walking machine
Walking speed of 1-2 km / hour, 2-3 minutes each time
5.Bicycle for exercise
Riding speed of 10-15 km / h, 2-3 minutes each time
6.Step exercise
Use the steps for up and down exercise, step height 35 cm each time up and down exercise for 2-3 minutes
7.Various exercise machines
Each action repeated 5-10 minutes