【目的 评价基于国际功能、残疾和健康分类(international classification of functioning,disability and health,ICF)框架的步行运动干预对维持性血液透析(maintenance hemodialysis,MHD)患者的影响。 方法 选取2023年3月—9月在西安交通大学第一附属医院血液净化科治疗的90例MHD患者，随机分为干预组和对照组(各45例)。对照组接受常规护理，干预组在常规护理基础上接受为期6个月基于ICF框架的信息化步行运动干预。比较干预前后2组6分钟步行距离、简易身体功能、周平均步数、握力、运动自我效能、社会支持、生活质量及生化指标的变化。 结果 共82例患者完成所有结局指标测评，干预组与对照组各41例。运动干预6个月后，干预组6分钟步行距离(t=-2.173， P=0.033)、身体功能(t=-3.605，P＜0.001)、周平均步数(t=-7.704，P＜0.001)、运动自我效能(t=-3.365，P＜0.001)、社会支持(t=-5.255，P＜0.001)及生活质量(t=-3.263，P=0.002)较对照组提高，握力 (t=-1.914，P=0.059)、血红蛋白(t=-1.050，P=0.147)、白蛋白(t=-1.243，P=0.537)、血钙(t=0.575，P=0.405)、血磷(t=0.238，P=0.896)等生化指标较对照组无显著改变。 结论 基于ICF框架的信息化步行运动干预有助于提高MHD患者的身体功能、运动自我效能及生活质量。
Objective To evaluate the effects of informational walking exercise intervention based on the International Classification of Functioning, Disability and Health (ICF) on maintenance hemodialysis (MHD) patients. Methods A total of 90 MHD patients treated at Xi’an Jiaotong University First Hospital from March to September 2023 were randomly assigned into intervention group (n=45) or control group (n=45). The control group received routine care, while the intervention group received the ICF-based digital walking exercise intervention plus routine care for 6 months. Six-minute walking distance (6MWD), physical function, number of weekly steps, grip strength, exercise self-efficacy, social support, quality of life, and biochemical indicators were compared before and after the intervention. Results A total of 82 patients (41 in each group) completed the study. After 6 months of walking exercise intervention, the intervention group showed significant improvements in 6MWD (t=-2.173, P=0.033), physical function (t=-3.605, P<0.001), average weekly steps (t=-7.704, P<0.001), exercise self-efficacy (t=-3.365, P<0.001), social support (t=-5.255, P<0.001), and quality of life (t=-3.263, P=0.002) as compared those to the control group. However, no significant changes were observed in grip strength (t=-1.914, P=0.059) and biochemical parameters including hemoglobin (t=-1.050, P=0.147), albumin (t=-1.243, P=0.537), calcium (t=0.575, P=0.405), and phosphorus (t=0.238, P=0.896). Conclusion The ICF-based informational walking intervention significantly improved physical function, exercise self-efficacy, and quality of life in MHD patients.
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