Publications by authors named "Stefania S Grigoriou"

6 Publications

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Long-term intradialytic hybrid exercise training on fatigue symptoms in patients receiving hemodialysis therapy.

Int Urol Nephrol 2021 Apr 2;53(4):771-784. Epub 2021 Jan 2.

Live Lab, Department of PE and Sport Science, University of Thessaly, 42100, Trikala, Greece.

Purpose: Hemodialysis (HD) patients suffer from generalized weakness, exercise intolerance and muscle atrophy, all leading to generalized fatigue and lack of energy. HD patients spend at least 50% of their time in a functionally "switch off" mode with their fatigue sensations reaching a peak in the immediate hours after the dialysis session. The purpose of the current study was to assess the effectiveness of a nine-month hybrid intradialytic exercise program on fatigue symptoms occurring during and after hemodialysis session.

Methods: Twenty stable hemodialysis patients were included in the study (59 ± 13.7 years; 16 males). All patients completed a 9-month supervised exercise training program composed of both aerobic cycling and resistance training during HD. Aspects related to physical and generalized fatigue were assessed via validated questionnaires, while physical performance was assessed by a battery of tests, before and after the intervention period.

Results: Exercise capacity and physical performance were increased by an average of 65 and 40%, respectively. Patients reported feeling better during post-dialysis hours in question 1 (p = 0.000), question 3 (p = 0.009) and question 4 (p = 0.003) after the 9-month intervention. In addition, exercise training improved scores in cognitive function (p = 0.037), vitality (p = 0.05), depression (p = 0.000) and fatigue (p = 0.039).

Conclusion: The present study showed that a 9-month hybrid (aerobic + resistance) exercise training program improved symptoms of post-dialysis fatigue and overall general perception of fatigue. Hybrid exercise training is a safe and effective non-pharmacological approach to ameliorate fatigue symptoms in HD patients.

Trial Registration Number: Trial registration number The study is registered at ClinicalTrials.gov (NCT01721551, 2012) as a clinical trial.
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http://dx.doi.org/10.1007/s11255-020-02711-8DOI Listing
April 2021

Effects of 12 months of detraining on health-related quality of life in patients receiving hemodialysis therapy.

Int Urol Nephrol 2020 Sep 14;52(9):1771-1778. Epub 2020 Aug 14.

Department of PE and Sport Science, University of Thessaly, Trikala, Greece.

Purpose: Limited data exist regarding the effects of detraining on functional capacity and quality of life (QoL) in the hemodialysis population. The aim of the current study was to assess whether the discontinuation from a systematic intradialytic exercise training program will affect aspects of health-related QoL and functional capacity in hemodialysis patients.

Methods: Seventeen hemodialysis patients (12 Males/5 Females, age 60.8 ± 13.6 year) participated in this study. Patients were assessed for functional capacity using various functional capacity tests while QoL, daily sleepiness, sleep quality, depression and fatigue were assessed using validated questionnaires at the end of a 12-month aerobic exercise program and after 12 months of detraining.

Results: The detraining significantly reduced patients' QoL score by 20% (P = 0.01). More affected were aspects related to the physical component summary of the QoL (P < 0.001) rather than those related to the mental one (P = 0.096). In addition, the performance in the functional capacity tests was reduced (P < 0.05), while sleep quality (P = 0.020) and daily sleepiness scores (P = 0.006) were significantly worse after the detraining period. Depressive symptoms (P = 0.214) and the level of fatigue (P = 0.163) did not change significantly.

Conclusions: Detraining has a detrimental effect in patients' QoL, functional capacity and sleep quality. The affected physical health contributed significantly to the lower QoL score. It is crucial for the chronic disease patients, even during emergencies such as lockdowns and restrictions in activities to maintain a minimum level of activity to preserve some of the acquired benefits and maintain their health status.
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http://dx.doi.org/10.1007/s11255-020-02560-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426199PMC
September 2020

Cardiac autonomic function during intradialytic exercise training.

Postgrad Med 2019 Sep 15;131(7):539-545. Epub 2019 Sep 15.

Department of Physical Education & Sport Science, University of Thessaly , Trikala , Greece.

: Cardiac autonomic nervous system (ANS) dysfunction is a common feature in patients receiving hemodialysis (HD) therapy, whilst is associated with an increased risk of ventricular arrhythmias and sudden cardiac death. The aim of this study is to investigate and compare the hemodynamic changes and responses of ANS function in HD patients using pupillometry and Heart Rate Variability (HRV) parameters. : Sixteen chronic kidney diseases (CKD) patients receiving HD (52.18 ± 17.7 years) underwent both pupillometric measurements using a portable handheld pupil-measuring device and standard HRV analysis pre HD, every hour and 30 min post-HD session under two different scenarios: at rest while the patient resting at HD bed and when the patient performed a single bout of intradialytic aerobic exercise lasting for 45 min during the second hour of the HD therapy. : No significant changes in ANS values were observed in neither of the pupillometric and the HRV values pre HD, for each hour and post-HD session. HRV parameters were significantly correlated with pupillometric parameters at pre HD and immediately after the single bout of intradialytic exercise. ANS activity did not differ during the conventional HD session and during the session included intradialytic exercise. Moreover, sympatho-vagal balance indices deriving from pupillometric assessment showed beneficial changes after the exercise event. : Pupillometry is a promising and robust technique with fewer artifacts compared to HRV especially in studies involving exercise sessions. Thus, pupillometry can be used as a complementary tool in the evaluation of cardiac autonomic dysfunction.
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http://dx.doi.org/10.1080/00325481.2019.1663707DOI Listing
September 2019

Pharmacological and Non-pharmacological Treatment Options for Depression and Depressive Symptoms in Hemodialysis Patients.

Health Psychol Res 2015 Apr 13;3(1):1811. Epub 2015 Apr 13.

Department of Physical Education and Sport Science, University of Thessaly, Trikala; Institute of Research and Technology Thessaly, Centre for Research and Technology-Hellas , Trikala, Greece.

Depression is a mental disorder with a high prevalence among patients with end stage renal disease (ESRD). It is reported that depression afflicts approximately 20-30% of this patient population, being associated, amongst other, with high mortality rate, low adherence to medication and low perceived quality of life. There is a variety of medications known to be effective for the treatment of depression but due to poor adherence to treatment as well as due to the high need for medications addressing other ESRD comorbidities, depression often remains untreated. According to the literature, depression is under-diagnosed and undertreated in the majority of the patients with chronic kidney disease. In the current review the main pharmacological and non-pharmacological approaches and research outcomes for the management of depressive symptoms in hemodialysis patients are discussed.
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http://dx.doi.org/10.4081/hpr.2015.1811DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4768541PMC
April 2015

Cognitive function and exercise training for chronic renal disease patients: A literature review.

J Bodyw Mov Ther 2015 Jul 18;19(3):509-15. Epub 2015 Apr 18.

Department of PE and Sport Science, University of Thessaly, Trikala, Greece; Department of Medicine, Division of Nephrology, University of Thessaly, Greece.

Objective: Cognitive impairment is very often noted in patients with Chronic Kidney Disease (CKD). Even though, exercise is considered to be a quantifiable activity that improves cognition in animals and humans, it seems that few studies have examined the relationship between cognitive function and CKD from the perspective of physical activity and cognitive performance. Thus, this evidence based review summarizes the present level of knowledge regarding the effects of exercise training on cognitive function in CKD patients.

Data Sources: A comprehensive literature search was conducted in PubMed and Scopus from May 2014 through June 2014, by using the Cochrane and PRISMA guidelines.

Review Methods: Eligibility of the studies based on titles, abstracts and full-text articles was determined by two reviewers. Studies were selected using inclusion and exclusion criteria. We included only those studies that: assessed cognitive function in humans and animals using validated neuropsychological methods in chronic renal diseases patients; used exercise training protocols; addressed randomized control trials or controlled trials or clinical trials designed to evaluate cognitive impairment; and articles that were written in English. Studies were excluded when they concerned behavioral approaches and underpowered studies.

Results: According to the current review only a few studies have examined the issue of cognitive function in CKD patients. These studies indicate that these patients often exhibit cognitive impairment, which is highly associated with poor outcomes. It has been supported that exercise training can induce positive changes in brain metabolism favoring better scores in cognitive function in Chronic Kidney Disease patients although the physiological mechanisms, which explain the influence of physical activity on cognition, have focused on changes in neurotransmitters, neurotrophins and vasculature.

Conclusion: Systematic exercise training seems to improve cognitive function in Chronic Kidney Disease patients but further research is warranted to further clarify the mechanisms involved.
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http://dx.doi.org/10.1016/j.jbmt.2015.04.006DOI Listing
July 2015

Exercise training and depression in ESRD: a review.

Semin Dial 2013 Sep-Oct;26(5):604-13. Epub 2013 Jul 9.

Department of PE and Sport Science, University of Thessaly, Trikala, Greece.

Depression, a mental disorder with a high personal, societal, and economic impact, affects at least 20-30% of patients receiving hemodialysis therapy. It is associated with a high mortality rate, low adherence to medication, and a low perceived quality of life. Exercise training is a promising nonpharmacological intervention that can be safely applied to these patients. Beyond the well-publicized physiological benefits of exercise training, a number of studies have focused on the effects of exercise training on mental factors and quality of life parameters including its less appreciated effects on depression symptoms. This evidence-based review article reviews and discusses the effects of exercise training on depression in end-stage renal disease patients.
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http://dx.doi.org/10.1111/sdi.12112DOI Listing
May 2014