护理学报 ›› 2019, Vol. 26 ›› Issue (1): 40-44.doi: 10.16460/j.issn1008-9969.2019.01.040
慢性肾脏病中晚期患者体力活动干预方案及评估工具研究进展
李燕, 单亚维, 张翠娣
- 上海中医药大学 护理学院,上海 200120
摘要： 目的 总结慢性肾脏病中晚期患者体力活动干预研究现状和评估工具研究进展。方法 计算机检索国内外有关慢性肾脏病中晚期患者体力活动及评估工具的研究文献,活动方案从活动的强度、时间和频率、活动类型及安全性等角度进行分析总结,体力活动干预的评估分主观和客观进行归纳分析。结果 国内对该人群研究较少,国外研究较为全面深入,大部分推荐中等强度活动并逐渐重视抗阻运动,但干预方案在时间和频次上差异较大。体力活动干预评估方法多且杂,但缺乏针对性。结论 目前对中晚期慢性肾脏病患者的体力活动指导尚无统一标准,大多数学者推荐中等强度的活动,抗阻运动逐渐得到重视,但活动类型仍比较单一,而最适宜的活动时间和频率尚不明晰,安全保障不够充分。未来应重视我国中晚期慢性肾脏病患者的体力活动现状,积极开展相关研究,尤其是大样本、长周期的干预或回顾性研究,以明确高强度活动的适用性、最佳的活动时间和频率等问题,从而构建最适宜这类患者的活动方案。
中图分类号:
- R473.5
| [1] Levey A S, De Jong P E, Coresh J, et al. The Definition, Cassification, and Prognosis of Chronic Kidney Disease: A KDIGO Controversies Conference Report[J]. Kidney Int, 2011, 80(1):17-28.DOI:10.1038/ki.2011.310. [2] Zhang L, Wang F, Wang L, et al.Prevalence of Chronic Kidney Disease in China: A Cross-sectional Survey[J].Lancet,2012,379(9818):815-822. DOI:10.1016/S0140-6736(12)60033-6. [3] Jha V, Gareia G, Iseki K, et al.Chronic Kidney Disease: Global Dimension and Perspective[J]. Lancet, 2013, 382(9888):260-272.DOI:10.1016/S0140-6736(13)60687-X. [4] Roshanravan B, Robinsoncohen C, Patel K V, et al.Association between Physical Performance and All-cause Mortality in CKD[J]. J Am Soc Nephrol, 2013, 24(5):822-830. DOI: 10.1681/ASN.2012070702. [5] 倪云霞,刁永书,陈志文,等.慢性肾脏病患者自我管理测评工具研究进展[J].护理学报, 2017, 24(18):25-29.DOI:10.16460/j.issn1008-9969.2017.18.025. [6] Howden E J, Coombes J S, Strand H, et al.Exercise Training in CKD: Efficacy, Adherence, and Safety[J]. Am J Kidney Dis, 2015, 65(4):583-591. DOI:10.1053/j.ajkd.2014.09.017. [7] Kosmadakis G C, Bevington A, Smith A C, et al.Physical Exercise in Patients with Severe Kidney Disease[J]. Nephron Clin Pract, 2010, 115(1):c7-c16.DOI:10.1159/000286344. [8] Padilla J, Krasnoff J, Da S M, et al.Physical Functioning in Patients with Chronic Kidney Disease[J]. J Nephrol, 2008, 21(4):550-559. [9] Brodin E, Ljungman S, Sunnerhagen K S.Rising from A Chair: A Simple Screening Ttest for Physical Function in Predialysis Patients[J]. Scand J Urol, 2008, 42(3):293-300.DOI:10.1080/00365590701797556. [10] Tawney K W, Tawney P J, Kovach J.Disablement and Rehabilitation in End-stage Renal Disease[J]. Semin Dial, 2003, 16(6):447-452. [11] Aucella F, Battaglia Y, Bellizzi V, et al.Physical Exercise Programs in CKD: Lights, Shades and Perspectives[J]. J Nephrol, 2015, 28(2):143-150.DOI:10.1007/s40620-015-0209-x. [12] Kosmadakis G C, John S G, Clapp E L, et al.Benefits of Regular Walking Exercise in Advanced Pre-dialysis Chronic Kidney Disease[J]. Nephrol Dial Transplant,2012, 27(3):997-1004. DOI:10.1093/ndt/gfr364. [13] Pechter Ü, Raag M, Otsrosenberg M.Regular Aquatic Exercise for Chronic Kidney Disease Patients: A 10-year Follow-up Study[J]. Int J Rehabil Res, 2014, 37(3):251-255.DOI:10.1097/MRR.0000000000000063. [14] 张莉,马迎春.不同强度运动训练对慢性肾脏病患者肾功能影响的研究[J].中国血液净化, 2016, 15(1):42-44.DOI:10.3969/j.issn.1671-4091.2016.01.011. [15] Mustata S, Groeneveld S, Davidson W, et al.Effects of Exercise Training on Pphysical Iimpairment, Arterial Stiffness and Health-related Quality of Life in Patients with Chronic Kidney Disease: A Pilot Study[J]. Int Urol Nephrol, 2011, 43(4):1133-1141. DOI:10.1007/s11255-010-9823-7. [16] Smithc A C.Exercise in Kidney Disease and Diabetes: Time for Action[J]. J Re Care, 2012, 38:52-58.DOI:10.1111/j.1755-6686.2012.00279.x. [17] Marchon C, De Marco O, Da S V K, et al. Effects of Moderate Exercise on the Biochemical, Physiological, Morphological and Functional Parameters of the Aorta in the Presence of Estrogen Deprivation and Dyslipidemia: An Experimental Model[J]. Cell Physiol Biochem, 2015, 35(1):397-405.DOI:10.1159/000369705. [18] Van Craenenbroeck A H, Van Craenenbroeck E M, Van A K, et al. Effect of Moderate Aerobic Exercise Training on Endothelial Function and Arterial Stiffness in CKD Stages 3-4: A Randomized Controlled Trial[J]. Am J Kidney Dis, 2015, 66(2):285. DOI:10.1053/j.ajkd.2015.03.015. [19] 韩勇. 运动疗法治疗失眠的中西医研究进展[J].内江科技, 2010, 31(5):39.DOI:10.3969/j.issn.1006-1436.2010.05.033. [20] National Kidney Foundation.KDIGO Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease[J].Kidney Int Suppl,2012,2:337-414. [21] Hamada M, Yasuda Y, Kato S, et al.The Effectiveness and Safety of Modest Exercise in Japanese Patients with Chronic Kidney Disease: A Single-armed Interventional Study[J]. Clini Exp Nephrol,2016,20(2):204-211.DOI:10.1007/s10157-015-1147-6. [22] Finkelstein J, Joshi A, Hise M K.Association of Physical Activity and Renal Function in Subjects with and without Metabolic Syndrome: A Review of the Third National Health and Nutrition Examination Survey (NHANES III)[J]. Am J Kidney Dis, 2006, 48(3):372-382. [23] 陈巧林,胡嘉波,顾可梁,等.剧烈运动引起肾功能异常变化的初步研究[J].浙江检验医学,2003, 18(3):360-363.DOI:10.3969/j.issn.1673-8640.2003.06.023. [24] Greenwood S A, Koufaki P, Mercer T H, et al.Effect of Exercise Training on Estimated GFR, Vascular Health, and Cardiorespiratory Fitness in Patients With CKD: A Pilot Randomized Controlled Trial[J]. Am J Kidney Dis, 2015, 65(3):425-434.DOI:10.1053/j.ajkd.2014.07.015. [25] National Collaborating Centre for Chronic Conditions. Chronic Kidney Disease: National Clinical Guideline for Early Identification and Management in Adults in Primaryand Secondary Care[R]. London: Royal College of Physicians,2008. [26] Leehey D J, Collins E, Kramer H J, et al.Structured Exercise in Obese Diabetic Patients with Chronic Kidney Disease: A Randomized Controlled Trial[J]. Am J Nephrol, 2016, 44(1):54. DOI:10.1159/000447703. [27] Rossi A P, Burris D D, Lucas F L, et al.Effects of a Renal Rehabilitation Exercise Program in Patients with CKD: A Randomized, Controlled Trial[J]. Clin J Am Soc Nephrol, 2014, 9(12):2052.DOI:10.2215/CJN.11791113. [28] Heiwe S, Jacobson S H. Exercise Training for Adults with Chronic Kidney Disease[J]. Cochrane Database Syst Rev, 2011,66(10):CD003236.DOI:10.1002/14651858.CD003236.pub2. [29] Clyne N. The Importance of Exercise Training in Predialysis Patients with Chronic Kidney disease[J]. Clin Nephrol, 2004, 61 Suppl 1(Suppl 1):S10. [30] 周方,赵志刚,王磊,等.中等强度有氧运动对慢性肾病患者峰值摄氧量和无氧阈的影响[J].中国康复医学杂志,2017, 32(5):525-529.DOI:10.3969/j.issn.1001-1242.2017.05.006. [31] Castaneda C, Gordon P L, Parker R C, et al.Resistance Training to Reduce the Malnutrition-inflammation Complex Syndrome of Chronic Kidney Disease[J]. Am J Kidney Dis, 2004, 43(4):607. [32] Fouque D, Kalantarzadeh K, Kopple J, et al.A Proposed Nomenclature and Diagnostic Criteria for Protein-energy Wasting in Acute and Chronic Kidney Disease[J]. Kidney Int, 2008, 73(4):391. [33] 卞凌云,徐丽,马金,等.56例慢性肾脏病营养不良患者个体化营养干预[J].护理学报, 2017, 24(7):55-57.DOI:10.16460/j.issn1008-9969.2017.07.055. [34] Cheema B S, Chan D, Fahey P, et al.Effect of Progressive Resistance Training on Measures of Skeletal Muscle Hypertrophy, Muscular Strength and Health-related Quality of Life in Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis[J]. Sports Med, 2014, 44(8):1125-1138. DOI:10.1007/s40279-014-0176-8. [35] 王超. 中国儿童青少年日常体力活动推荐量研究[D]. 上海:上海体育学院, 2013. [36] 屈宁宁,李可基.国际体力活动问卷中文版的信度和效度研究[J].中华流行病学杂志, 2004, 25(3):265-268. [37] 康茜,王丽娟.基于计划行为理论分析青少年休闲性体力活动的影响因素[J].中国学校卫生,2016, 37(6):851-855.DOI:10.16835/j.cnki.1000-9817.2016.06.013. [38] 陈芳莲,唐焕英.国际体力活动问卷在围绝经期女性的适用性研究[J].天津护理,2017, 25(1):20-22.DOI:10.3969/j.issn.1006-9143.2017.01.008. [39] 胡斌,林烂芳,袁子宇,等.3种体力活动测量问卷的效度研究[J].现代预防医学,2013, 40(16):3061-3065. [40] 王美凤,裴丽,张清,等.三种体力活动量表在2型糖尿病患者中应用的信效度检验[J].中国康复医学杂志,2016,31(9):945-949.DOI:10.3969/j.issn.1001-1242.2016.09.003. |
| [1] | 王娅敏, 郑晶, 赵文波, 彭晖, 李慧群. 基于PubMed慢性肾脏病患者运动研究共词热点聚类分析[J]. 护理学报, 2020, 27(8): 20-25. |
| [2] | 黄媛媛, 傅巧美, 刘光香, 白雅馨, 张青. 肾移植患者基于“互联网+”延续护理的效果观察[J]. 护理学报, 2020, 27(8): 69-72. |
| [3] | 李寅翠, 刘云, 李莹, 韩雪, 孟嘉. 术前睡眠质量对全膝关节表面置换患者术后早期康复及生活质量的影响[J]. 护理学报, 2020, 27(4): 42-47. |
| [4] | 刘熠, 欧阳艳琼, 黄毅, 聂小菲. 正念减压疗法对乳腺癌患者干预效果的Meta分析[J]. 护理学报, 2019, 26(8): 31-36. |
| [5] | 张鲁敏, 顾芬, 任皎皎, 陈刘莺. 叙事护理对COPD患者焦虑抑郁及生活质量的影响[J]. 护理学报, 2019, 26(7): 65-69. |
| [6] | 杜红娣, 刘彩云, 刘晓萱, 王琳琳, 李莹, 霍晓鹏. 基于蒙台梭利教育理论干预对轻中度老年痴呆患者认知功能及生活质量的影响[J]. 护理学报, 2019, 26(5): 59-62. |
| [7] | 朱冰洁, 李佳倩, 黄孟秋, 王蕊, 阎玲. 154例乳腺癌化疗患者症状管理自我效能影响因素分析[J]. 护理学报, 2019, 26(18): 42-46. |
| [8] | 于歌, 崔金金. 二元应对模式对慢性心力衰竭患者生活质量及其配偶间亲密关系的影响[J]. 护理学报, 2019, 26(16): 63-67. |
| [9] | 王玲,孙丹,郑莉. 肝移植受者术后小组活动健康教育的效果观察[J]. 护理学报, 2018, 25(6): 64-67. |
| [10] | 连冬梅,程蕾,宋红梅,李杨. 系统性红斑狼疮患者运动干预研究进展[J]. 护理学报, 2018, 25(5): 32-35. |
| [11] | 黄孟秋,吴婷,张青月,王燕,庞微,阎玲. 症状管理自我效能在乳腺癌患者化疗期间焦虑抑郁与生活质量的中介作用[J]. 护理学报, 2018, 25(4): 65-69. |
| [12] | 罗香莲, 黄雅莲, 方艳春, 宋春莲, 朱婷, 徐俊敏. 团体爱笑瑜伽对维持性血液透析患者生活质量的影响[J]. 护理学报, 2018, 25(22): 1-5. |
| [13] | 吴静, 丁晓平, 耿在香. 住院康复期精神分裂症患者正念训练的效果观察[J]. 护理学报, 2018, 25(20): 64-67. |
| [14] | 张琼,尹安春. 痴呆老人家庭照顾者生活质量及其影响因素研究进展[J]. 护理学报, 2018, 25(16): 22-26. |
| [15] | 陈洁,薄海欣,段艳萍. 女性不孕症患者生育生活质量及影响因素研究[J]. 护理学报, 2018, 25(13): 1-5. |
|