高齢の維持血液透析患者1症例に対する運動療法が身体機能へ与える長期効果：入院イベントを含む20カ月間の検討

抄録

【Objective】This case study aimed to evaluate the effect of exercise therapy on a physical function in an elderly patient undergoing outpatient maintenance hemodialysis over a 20-months period, including the period of outpatient dialysis visits and hospitalization due to the 12th thoracic vertebra. 【Case Presentation / Methods of Intervention】A woman in her eighties undergoing dialysis for chronic renal failure caused by chronic glomerulonephritis began exercise therapy during dialysis approximately 1.5 months after induction. Exercise therapy consisted of stretching and resistance training, with exercise intensity ranging from 11 to 13 on the Borg scale. During hospitalization due to the fracture, rehabilitation was provided on dialysis and non-dialysis days with the goal of discharge home was implemented. After discharge from the hospital, the patient continued the exercise therapy during dialysis. Grip strength, isometric knee extension strength, 10 m walking speed, short physical performance battery, and EuroQol-5D were used to assess the physical function and quality of life, respectively. 【Results】Seven assessments of physical function were conducted over a 20-month period, including hospitalization, and all the evaluations showed improvement three months after the initiation of exercise, a slight decline six months later, and no significant change after that. Rehabilitation was provided during hospitalization for the fracture event, and physical function was maintained during discharge. 【Discussion】This case report suggests that continuous exercise therapy and rehabilitation are important for maintaining physical function in both outpatient and inpatient settings. Maintaining and improving physical function requires seamless intervention by setting the exercise according to the exercise duration while assessing physical function.