Effects of cluster set resistance training on bone mineral density and markers of bone metabolism in older hemodialysis subjects: A pilot study

• Published in: Bone (New York, N.Y.) Vol. 189; p. 117240
• Main Authors: Magalhães de Castro, Bruno, dos Santos Rosa, Thiago, de Araújo, Thaís Branquinho, de Luca Corrêa, Hugo, de Deus, Lysleine Alves, Neves, Rodrigo Vanerson Passos, Reis, Andrea Lucena, dos Santos, Rafael Lavarini, da Silva Barbosa, Jéssica Mycaelle, de Sousa Honorato, Fernando, da Motta Vilalva Mestrinho, Vitória Marra, de Moraes, Milton Rocha, Tzanno-Martins, Carmen, Prestes, Jonato
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2024
• Subjects: Aged; Biomarkers - metabolism; Bone and Bones - metabolism; Bone Density - physiology; Bone metabolism; Bone mineral density; Female; Fibroblast Growth Factor-23; Hemodialysis; Humans; Male; Middle Aged; Pilot Projects; Renal Dialysis; Renal Insufficiency, Chronic - metabolism; Renal Insufficiency, Chronic - physiopathology; Renal Insufficiency, Chronic - therapy; Resistance training; Resistance Training - methods; Bone mineral density; Hemodialysis; Bone metabolism; Resistance training
• ISSN: 8756-3282; 1873-2763; 1873-2763
• DOI: 10.1016/j.bone.2024.117240

Chronic kidney disease (CKD) is associated with a series of mineral bone disturbances due to increased production of parathormone which increases the activity of osteoclasts, removing calcium and phosphorous from the bones. However, the literature lacks investigations on the feasibility of different resistance training (RT) methods, such as cluster-sets, in this population. Thus, the aim of the present study was to compare traditional versus cluster-set RT protocols on bone mineral density (BMD) T-score, BMD Total, femur BMD, L3-L4 BMD, femoral neck BMD, Klotho, FGF23, Klotho - FGF23 ratio, Sclerostin, vitamin D, phosphorous and calcium in older subjects with CKD. Seventy-eight older subjects (age: 57.55 ± 4.06 years, body mass: 72.26 ± 13.96 kg, body mass index: 26.73 ± 2.97 kg/m2) with CKD undergoing maintenance hemodialysis were randomly divided into control group (CG, n = 26), traditional RT (RT, n = 26) and cluster-set RT (RT-CS, n = 26) groups. Subjects completed 24 weeks of RT three times per week, 1 h and 30 min before the hemodialysis session, and each training lasted around 60 to 80 min. There was a group×time interaction for total BMD, femur BMD, L3-L4 BMD, and femoral neck BMD, revealed by improvements for RT and RT-CS groups (pre versus post). Only femur BMD displayed differences as compared with the CG. Minimum clinically important difference (MCID) values revealed more responsive subjects in the RT-CS group for total BMD, femur BMD, klotho, FGF23, sclerostin, Vitamin D and calcium. In conclusion, RT can be used as a non-pharmacological complementary strategy for the treatment of CKD. RT-CS may be useful for these subjects as more responders were found for this type of training. •Older individuals with CKD display significant improvement on total BMD, femur BMD, L3-L4 BMD and femoral neck BMD following RT intervention.•Physiological mechanisms involved in the improvement of BMD were revealed by modifications on Klotho, FGF23, Klotho-FGF23 Ratio, Sclerostin, and vitamin D induced by RT.•RT proved to be a valuable strategy for enhancing and maintaining bone health in older individuals with CKD.•Minimum clinically important difference (MCID) values revealed more responsive subjects in the RT-CS group for total BMD, femur BMD, klotho, FGF23, sclerostin, Vitamin D and calcium.•Our study highlights the CS method displays superior responsiveness in improving BMD and bone metabolism markers compared to traditional RT protocol.