# Objective and subjective measures of fatigability in Veterans with chronic kidney disease before and after flywheel resistance plus aerobic exercise

> **NIH VA IK2** · U.S. DEPT/VETS AFFAIRS MEDICAL CENTER · 2020 · —

## Abstract

Chronic kidney disease (CKD) is a complex medical condition affecting as much as 36% of the Veteran
population. Both empirical and anecdotal evidence identify elevations in fatigability as a major health concern
in Veterans with CKD predialysis. Neuromuscular deteriorations resulting from CKD are likely to contribute to
excessive fatigability, impacting an individual’s functional status. Flywheel resistance exercise (FRE) uses inertial
resistance to allow for optimal muscle loading through the entire concentric muscle action and promotes greater
eccentric force generation compared to traditional resistance exercise. FRE has been shown to be superior to
traditional resistance exercise for improving muscle strength, power, and physical function in healthy
populations suggesting it may be a useful treatment for addressing neuromuscular impairments and functional
decline. However, it is unclear if the addition of aerobic exercise to FRE would provide additive improvements
in fatigue resistance in patients with CKD, without compromising neuromuscular and functional benefits. The
purpose of this project is to (1) advance our understanding of performance fatigability and perceived fatigability,
and the association with neuromuscular capacity in Veterans with CKD stage 3 & 4 predialysis and (2) determine
the extent to which combination FRE plus aerobic exercise training can improve fatigability status,
neuromuscular capacity, and physical function in Veterans with CKD stage 3 & 4 predialysis. The central
hypothesis is that reductions in neuromuscular capacity are associated with increases in fatigability severity, and
that FRE plus aerobic exercise training will reduce fatigability severity while enhancing neuromuscular and
functional capabilities in Veterans with CKD stage 3 & 4 predialysis. To address this hypothesis, we will
characterize performance fatigability and perceived fatigability, and assess the associations between fatigability
outcomes and neuromuscular capacity in Veterans with CKD stage 3 & 4 predialysis and examine the effects of
12-weeks of FRE plus aerobic exercise training on changes in performance and perceived fatigability,
neuromuscular capacity, and physical function in Veterans with CKD stage 3 & 4 predialysis. Findings from this
project will provide valuable information for advancing the understanding of performance fatigability and
perceived fatigability, and their inter-relationship, in Veterans with CKD stages 3 and 4. Additionally, novel
evidence on the responsiveness of performance and perceived fatigability, neuromuscular capacity, and quality
of life to FRE plus aerobic exercise training will be gained.

## Key facts

- **NIH application ID:** 10069905
- **Project number:** 1IK2RX003423-01A1
- **Recipient organization:** U.S. DEPT/VETS AFFAIRS MEDICAL CENTER
- **Principal Investigator:** JARED M. GOLLIE
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2020-10-01 → 2026-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10069905

## Citation

> US National Institutes of Health, RePORTER application 10069905, Objective and subjective measures of fatigability in Veterans with chronic kidney disease before and after flywheel resistance plus aerobic exercise (1IK2RX003423-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10069905. Licensed CC0.

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