Metabolic Syndrome and Psychological Effects of Exercise in Hemodialysis Patients

Abstract

Metabolic syndrome (MS) and anxiety disorders are common problems among hemodialysis patients (HD). However, there have been no studies defining the role of physical activity in reducing anxiety in HD patients with MS. This study was aimed to determine the effects on the severity of anxiety of a four-week rehabilitation program for HD patients, with or without metabolic syndrome (MS), planned and adapted to their abilities. The study was single-center, interventional, non-randomized, and prospective. Fifty-eight individuals completed the project (28 HD patients and 30 controls (C) with normal kidney function). Each group was divided into two subgroups with respect to MS. The mean age of the subjects in the HD and C groups was 56.9 ± 13.3 years (x¯ ± SD) and 61.5 ± 8.3 years (x¯ ± SD), respectively. Planned and adapted to the patient’s abilities, the rehabilitation program based on physiotherapy was provided to each subject for 4 weeks. Baseline and post-intervention determined anxiety levels using the State-Trait Anxiety Inventory (STAI). The X1 scale tests state anxiety, and the X2 scale tests trait anxiety. Post-intervention, there was no significant difference in the intensity of state anxiety observed in HD patients compared to C with normal renal function, as observed before the program. After four weeks of regular physical activity planned and adapted to the patient’s abilities in an inpatient ward, the level of state anxiety (X1) and trait anxiety (X2) lowered considerably in all HD patients (respectively: 35.1 ± 8.0 vs. 29.2 ± 5.0, p = 0.001 for X1 and 41.8 ± 9.1 vs. 38.1 ± 5.9, p = 0.008 for X2). The rehabilitation program significantly reduced the intensity of state anxiety (X1) in HD patients with MS (35.8 ± 7.9 vs. 29.2 ± 5.1; p = 0.01). The rehabilitation program helped to significantly reduce the intensity of trait anxiety (X2) in HD patients without MS (41.9 ± 10.7 vs. 36.9 ± 5.9; p = 0.04). Four-week physical activity planned and adapted to the patient’s abilities reduces the intensity of anxiety in HD patients and controls with normal renal function. HD patients with MS benefit more in terms of reducing perceived state anxiety, and HD patients without MS in terms of reducing trait anxiety.