不同运动方式治疗血液透析患者睡眠障碍的网状Meta分析OACSTPCD

[Objective]To evaluate the efficacy and safety of different exercise modalities on sleep disorder in hemodialysis patients based on network Meta-analysis and to provide evidence-based medical evidence for clinical use.[Methods]A computerized search of PubMed,The Cochrane Library,EMbase,Web of Science,VIP,WanFang and CNKI databases was performed to collect randomized controlled trials(RCTs)of different exercise modalities on sleep disorder in hemodialysis patients.The search timeframe was from the construction of the library to May 31,2023.Meta-analysis was performed using RevMan 5.4 software and Stata 16.0 software after 2 investigators independently screened the literature,extracted the information and evaluated the risk of bias of the included studies.[Results]A total of 32 papers and 2 567 patients were included,involving 7 different exercise modalities(aerobic training,aerobic training + resistance training,aerobic training + Taichi,resistance training + Baduanjin,progressive muscle relaxation,Baduanjin,Taichi and Pilates).The results of the network Meta-analysis showed that,the top 3 interventions(SUCRA in parentheses)in terms of PSQI total were:Baduanjin(76.7%)＞Pilates(72.5%)＞aerobic training(67.6%).The top 3 interventions in terms of sleep quality were:aerobic training + resistance training(96.9%)＞resistance training + Baduanjin(68.4%)＞aerobic training(62.6%).The top 3 interventions in terms of sleep latency were:Baduanjin(100%)＞progressive muscle relaxation training(76.9%)＞aerobic training + resistance training(62.3%).The top 3 interventions in terms of sleep duration were:Baduanjin(97.9%)＞aerobic training + resistance training(67.3%)＞resistance training + Baduanjin(63.2%).The top 3 interventions in terms of sleep efficiency were:Taichi(91.7%)＞aerobic training + resistance training(85.3%)＞resistance training + Baduanjin(69.4%).The top 3 interventions in terms of sleep disorder were:Baduanjin(100%)＞resistance training + Baduanjin(74.4%)＞aerobic training(67%).The top 3 interventions in terms of daytime dysfunction were:Baduanjin(100%)＞resistance training + Baduanjin(81.6%)＞aerobic training + resistance training(67%).The top 3 interventions in terms of use of sleep medication were:Baduanjin(78.7%)＞aerobic training(71.2%)＞aerobic training + resistance training(63.3%).[Conclusion]Current evidence suggests that combining these eight different exercise modalities with conventional treatment can alleviate sleep disorder in hemodialysis patients,with the combined efficacy of the Baduanjin being the most effective.However,due to the number and quality of included studies,more high-quality RCTs need to be conducted to further validate this conclusion.