{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:15:09Z","timestamp":1771470909383,"version":"3.50.1"},"reference-count":69,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T00:00:00Z","timestamp":1686700800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>This randomized clinical trial aimed to examine the effects of a 6-month home-based, combined exercise training program on Cardiac Autonomic Neuropathy (CAN) in kidney transplant recipients (KTRs) with diabetes. Twenty-five KTRs (19 men (76.0%), with a mean age of 54.4 \u00b1 11.3 years old, CAN and type II Diabetes Mellitus (DM-II)), were randomly assigned into two groups: A (n1 = 13 KTRs), who underwent a home-based exercise training program for 6 months, and B (n2 = 12 KTRs), who were assessed at the end of the study. A cardiopulmonary exercise testing (CPET), sit-to-stand test in 30 s (30-s STS), isokinetic muscle strength dynamometry, and 24-h electrocardiographic monitoring were applied to all participants, both at the baseline and at the end of the clinical trial. At first, there were no statistically significant differences between groups. After 6 months, group A showed higher values in exercise time by 8.7% (p = 0.02), VO2peak by 7.3% (p &lt; 0.05), 30-s STS by 12.0% (p &lt; 0.05), upper limb strength by 46.1% (p &lt; 0.05), and lower limb strength by 24.6% (p = 0.02), respectively, compared to the B group. Furthermore, inter-group changes at the end of the 6-month study indicated that group A statistically increased the standard deviation of R-R intervals (SDNN) by 30.3% (p = 0.01), root mean square of successive differences between normal heartbeats (rMSSD) by 32.0% (p = 0.03), number of pairs of successive NN (R-R) intervals that differ by more than 50 ms (pNN50) by 29.0% (p = 0.04), high frequency (HF (ms2)) by 21.6% (p &lt; 0.05), HF (n.u.) by 48.5% (p = 0.01), and turbulence slope (TS) by 22.5% (p = 0.02), and decreased the low frequency (LF (ms2)) by 13.2% (p = 0.01), LF (n.u.) by 24.9% (p = 0.04), and LF\/HF ratio by 24% (p = 0.01), compared to group B. Linear regression analysis after the 6-month study showed that there was a strong positive correlation between VO2peak and SDNN (r = 0.701, p &lt; 0.05) in group A. Moreover, multiple regression analysis showed that KTRs\u2019 participation in the exercise program showed favorable modifications to sympathovagal balance and aerobic capacity, as measured with SDNN and VO2peak, respectively. To summarize, diabetic KTRs\u2019 cardiac autonomic function and functional capacity can be improved after a home-based long-term exercise training program.<\/jats:p>","DOI":"10.3390\/life13061394","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T01:32:57Z","timestamp":1686792777000},"page":"1394","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Home-Based Exercise Training and Cardiac Autonomic Neuropathy in Kidney Transplant Recipients with Type-II Diabetes Mellitus"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7097-2927","authenticated-orcid":false,"given":"Vassiliki","family":"Michou","sequence":"first","affiliation":[{"name":"Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2961-7066","authenticated-orcid":false,"given":"Maria","family":"Nikodimopoulou","sequence":"additional","affiliation":[{"name":"Transplant Surgery Clinic of Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7564-2724","authenticated-orcid":false,"given":"Vassilios","family":"Liakopoulos","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Anifanti","sequence":"additional","affiliation":[{"name":"Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Papagianni","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hippokration Hospital, Aristotle University, 54642 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8821-406X","authenticated-orcid":false,"given":"Pantelis","family":"Zembekakis","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, 1st Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-1897","authenticated-orcid":false,"given":"Asterios","family":"Deligiannis","sequence":"additional","affiliation":[{"name":"Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-2542","authenticated-orcid":false,"given":"Evangelia","family":"Kouidi","sequence":"additional","affiliation":[{"name":"Sports Medicine Laboratory, School of Physical Education & Sport Science, Aristotle University, 57001 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"ref_1","first-page":"49","article-title":"Diabetic kidney disease: World wide difference of prevalence and risk factors","volume":"5","author":"Gheith","year":"2016","journal-title":"J. Nephropharmacol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1053\/j.ajkd.2017.12.005","article-title":"Physical Activity in Kidney Transplant Recipients: A Review","volume":"72","author":"Takahashi","year":"2018","journal-title":"Am. J. Kidney Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"576","DOI":"10.12659\/AOT.891265","article-title":"Assessment of Health-Related Quality of Life of Patients after Kidney Transplantation in Comparison with Hemodialysis and Peritoneal Dialysis","volume":"19","author":"Kurowski","year":"2014","journal-title":"Ann. Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s11906-021-01129-6","article-title":"Autonomic Cardiovascular Alterations in Chronic Kidney Disease: Effects of Dialysis, Kidney Transplantation, and Renal Denervation","volume":"23","author":"Seravalle","year":"2021","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1111\/j.1600-6143.2004.00573.x","article-title":"Kidney Transplantation Halts Cardiovascular Disease Progression in Patients with End-Stage Renal Diseas","volume":"4","author":"Schold","year":"2004","journal-title":"Am. J. Transplant."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2337\/dc09-1294","article-title":"Cardiac Autonomic Neuropathy in Diabetes","volume":"33","year":"2010","journal-title":"Diabetes Care"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s11892-006-0074-z","article-title":"Cardiovascular autonomic neuropathy: Diagnosis and management","volume":"6","author":"Vinik","year":"2006","journal-title":"Curr. Diabetes Rep."},{"key":"ref_8","first-page":"1114","article-title":"Improvement of cardiac sympathetic innervation by renal transplantation","volume":"45","author":"Kurata","year":"2004","journal-title":"J. Nucl. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1972","DOI":"10.1681\/ASN.V1091972","article-title":"Heart Rate Variability during Chronic Hemodialysis and after Renal Transplantation","volume":"10","author":"Rubinger","year":"1999","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1007\/s11906-015-0571-z","article-title":"Cardiovascular Autonomic Dysfunction in Chronic Kidney Disease: A Comprehensive Review","volume":"17","author":"Salman","year":"2015","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"ii15","DOI":"10.1093\/ckj\/sfab022","article-title":"Exercise training in patients after kidney transplantation","volume":"14","year":"2021","journal-title":"Clin. Kidney J."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Rysz, J., Franczyk, B., Radek, M., Cia\u0142kowska-Rysz, A., and Gluba-Brz\u00f3zka, A. (2021). Diabetes and Cardiovascular Risk in Renal Transplant Patients. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073422"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1056\/NEJMra033540","article-title":"Immunosuppressive Drugs for Kidney Transplantation","volume":"351","author":"Halloran","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/TP.0000000000002543","article-title":"Correlates and Outcomes of Low Physical Activity Posttransplant: A Systematic Review and Meta-Analysis","volume":"103","author":"Berben","year":"2019","journal-title":"Transplantation"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1111\/j.1432-2277.2009.00917.x","article-title":"Longitudinal analysis of physical activity, fluid intake, and graft function among kidney transplant recipients","volume":"22","author":"Gordon","year":"2009","journal-title":"Transpl. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1093\/ndt\/gfs455","article-title":"A randomized controlled trial of exercise training on cardiovascular and autonomic function among renal transplant recipients","volume":"28","author":"Kouidi","year":"2013","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Michou, V., Liakopoulos, V., Roumeliotis, S., Roumeliotis, A., Anifanti, M., Tsamos, G., Papagianni, A., Zempekakis, P., Deligiannis, A., and Kouidi, E. (2023). Effects of Home-Based Exercise Training on Cardiac Autonomic Neuropathy and Metabolic Profile in Diabetic Hemodialysis Patients. Life, 13.","DOI":"10.3390\/life13010232"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.rehab.2019.08.003","article-title":"Accuracy of modified 30-s chair-stand test for predicting falls in older adults","volume":"63","author":"Roongbenjawan","year":"2020","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2828","DOI":"10.1080\/09638288.2019.1575922","article-title":"What is the optimal chair stand test protocol for older adults? A systematic review","volume":"42","author":"Mehmet","year":"2020","journal-title":"Disabil. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/02701367.1999.10608028","article-title":"A 30-s Chair-Stand Test as a Measure of Lower Body Strength in Community-Residing Older Adults","volume":"70","author":"Jones","year":"1999","journal-title":"Res. Q. Exerc. Sport"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"907","DOI":"10.26603\/001c.36432","article-title":"Normative Reference Values and Validity for the 30-Second Chair-Stand Test in Healthy Young Adults","volume":"17","author":"Lein","year":"2022","journal-title":"Int. J. Sport. Phys. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1111\/ctr.12796","article-title":"Feasibility of exercise stress echocardiography for cardiac risk assessment in chronic kidney disease patients prior to renal transplantation","volume":"30","author":"Nerlekar","year":"2016","journal-title":"Clin. Transplant."},{"key":"ref_23","first-page":"514","article-title":"Heart rate variability: A noninvasive electrocardiographic method to measure the autonomic nervous system","volume":"134","author":"Sztajzel","year":"2004","journal-title":"Swiss Med. Wkly."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1136\/hrt.71.1.1","article-title":"Power spectrum analysis of heart rate variability: A tool to explore neural regulatory mechanisms","volume":"71","author":"Malliani","year":"1994","journal-title":"Heart"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1161\/01.CIR.84.2.482","article-title":"Cardiovascular neural regulation explored in the frequency domain","volume":"84","author":"Malliani","year":"1991","journal-title":"Circulation"},{"key":"ref_26","first-page":"1043","article-title":"Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Heart rate variability: Standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology","volume":"93","author":"Malik","year":"1996","journal-title":"Circulation"},{"key":"ref_27","first-page":"10","article-title":"Heart Rate Turbulence: A Review","volume":"3","author":"Watanabe","year":"2003","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.pcad.2013.08.002","article-title":"Heart Rate Turbulence","volume":"56","author":"Cygankiewicz","year":"2013","journal-title":"Prog Cardiovasc Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1016\/j.jacc.2008.07.041","article-title":"Heart Rate Turbulence: Standards of Measurement, Physiological Interpretation, and Clinical Use: International Society for Holter and Noninvasive Electrophysiology Consensus","volume":"52","author":"Bauer","year":"2008","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/S0140-6736(98)08428-1","article-title":"Heart-rate turbulence after ventricular premature beats as a predictor of mortality after acute myocardial infarction","volume":"353","author":"Schmidt","year":"1999","journal-title":"Lancet"},{"key":"ref_31","unstructured":"World Health Organization (2020). WHO Guidelines on Physical Activity and Sedentary Behaviour, World Health Organization."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1007\/s40620-019-00583-5","article-title":"Exercise training in kidney transplant recipients: A systematic review","volume":"32","author":"Calella","year":"2019","journal-title":"J. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"396","DOI":"10.9734\/BJAST\/2015\/14975","article-title":"Likert Scale: Explored and Explained","volume":"7","author":"Joshi","year":"2015","journal-title":"Br. J. Appl. Sci. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/B978-0-444-53491-0.00013-4","article-title":"Exercise and the autonomic nervous system","volume":"117","author":"Fu","year":"2013","journal-title":"Handb. Clin Neurol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1152\/japplphysiol.00674.2015","article-title":"Cardiovascular control during whole body exercise","volume":"121","author":"Volianitis","year":"2016","journal-title":"J. Appl. Physiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"329","DOI":"10.3109\/07853899109148068","article-title":"Blood Pressure Regulation during Exercise","volume":"23","author":"Rowell","year":"1991","journal-title":"Ann. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1294","DOI":"10.1152\/jappl.1965.20.6.1294","article-title":"Renal clearances during prolonged supine exercise at different loads","volume":"20","author":"Grimby","year":"1965","journal-title":"J. Appl. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1152\/jappl.1975.38.1.70","article-title":"Glucagon and plasma catecholamine responses to graded and prolonged exercise in man","volume":"38","author":"Galbo","year":"1975","journal-title":"J. Appl. Physiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.neubiorev.2008.04.009","article-title":"Individual responses to aerobic exercise: The role of the autonomic nervous system","volume":"33","author":"Hautala","year":"2009","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s004210170003","article-title":"Post-exercise recovery of autonomic cardiovascular control: A study by spectrum and cross-spectrum analysis in humans","volume":"84","author":"Terziotti","year":"2001","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1007\/s00421-004-1119-0","article-title":"Short- and long-term effects of a single bout of exercise on heart rate variability: Comparison between constant and interval training exercises","volume":"92","author":"Mourot","year":"2004","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1046\/j.1365-2281.2001.00309.x","article-title":"Changes in cardiac autonomic regulation after prolonged maximal exercise","volume":"21","author":"Hautala","year":"2001","journal-title":"Clin. Physiol. Funct. Imaging"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.dsx.2017.08.015","article-title":"Exercise training and cardiac autonomic function in type 2 diabetes mellitus: A systematic review","volume":"12","author":"Bhati","year":"2018","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1042\/cs0970005","article-title":"Role of nitric oxide in the regulation of cardiovascular autonomic control","volume":"97","author":"Chowdhary","year":"1999","journal-title":"Clin Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1161\/01.HYP.25.6.1270","article-title":"Modulation of Cardiac Autonomic Control in Humans by Angiotensin II","volume":"25","author":"Townend","year":"1995","journal-title":"Hypertension"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Daniela, M., Catalina, L., Ilie, O., Paula, M., Daniel-Andrei, I., and Ioana, B. (2022). Effects of Exercise Training on the Autonomic Nervous System with a Focus on Anti-Inflammatory and Antioxidants Effects. Antioxidants, 11.","DOI":"10.3390\/antiox11020350"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"401","DOI":"10.2165\/00007256-200838050-00004","article-title":"Catecholamines and the Effects of Exercise, Training and Gender","volume":"38","author":"Zouhal","year":"2008","journal-title":"Sport. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"921","DOI":"10.2105\/AJPH.2007.133165","article-title":"The Effect of Aerobic Training and Cardiac Autonomic Regulation in Young Adults","volume":"99","author":"Sloan","year":"2009","journal-title":"Am. J. Public Health"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1038\/hr.2011.162","article-title":"Physical exercise improves cardiac autonomic modulation in hypertensive patients independently of angiotensin-converting enzyme inhibitor treatment","volume":"35","author":"Cozza","year":"2012","journal-title":"Hypertens. Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2588","DOI":"10.1161\/01.CIR.102.21.2588","article-title":"Effects of a Residential Exercise Training on Baroreflex Sensitivity and Heart Rate Variability in Patients With Coronary Artery Disease","volume":"102","author":"Iellamo","year":"2000","journal-title":"Circulation"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1177\/1359105316676329","article-title":"Effect of exercise training in heart rate variability, anxiety, depression, and sleep quality in kidney recipients: A preliminary study","volume":"24","author":"Barroso","year":"2019","journal-title":"J. Health Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"(1996). Electrophysiology TF of the ES of C the NA. Heart Rate Variability. Circulation, 93, 1043\u20131065.","DOI":"10.1161\/01.CIR.93.5.1043"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"107813","DOI":"10.1016\/j.diabres.2019.107813","article-title":"Impaired heart rate variability, Valsalva and 30:15 ratio indexes are associated with reduced submaximal exercise capacity in subjects with diabetes mellitus","volume":"155","author":"Bonete","year":"2019","journal-title":"Diabetes Res. Clin. Pr."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1111\/1440-1681.12481","article-title":"Autonomic modulation analysis in active and sedentary kidney transplanted recipients","volume":"42","author":"Rodrigues","year":"2015","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/S1388-9842(01)00221-5","article-title":"Recovery of cardiac autonomic responsiveness with low-intensity physical training in patients with chronic heart failure","volume":"4","author":"Malfatto","year":"2002","journal-title":"Eur. J. Heart Fail."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1111\/j.1540-8159.2008.02266.x","article-title":"Variable Effects of Physical Training of Heart Rate Variability, Heart Rate Recovery, and Heart Rate Turbulence in Chronic Heart Failure","volume":"32","author":"Piotrowicz","year":"2009","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s102860200025","article-title":"The influence of autonomic neuropathy on hypotension during hemodialysis","volume":"12","author":"Calvo","year":"2002","journal-title":"Clin. Auton. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e8296","DOI":"10.1097\/MD.0000000000008296","article-title":"Combination of Ewing test, heart rate variability, and heart rate turbulence analysis for early diagnosis of diabetic cardiac autonomic neuropathy","volume":"96","author":"Lin","year":"2017","journal-title":"Medicine"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1016\/j.amjcard.2007.03.106","article-title":"Heart Rate Variability and Heart Rate Turbulence in Patients With Type 2 Diabetes Mellitus With Versus Without Cardiac Autonomic Neuropathy","volume":"100","author":"Arslan","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1097\/00007890-200207150-00008","article-title":"A randomized trial of exercise training after renal transplantation","volume":"74","author":"Painter","year":"2002","journal-title":"Transplantation"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1016\/S0272-6386(03)00673-5","article-title":"Effects of exercise training on coronary heart disease risk factors in renal transplant recipients","volume":"42","author":"Painter","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.jcjd.2015.08.014","article-title":"Impact of Resistance Training on Factors Involved in the Development of New-Onset Diabetes After Transplantation in Renal Transplant Recipients: An Open Randomized Pilot Study","volume":"40","author":"Karelis","year":"2016","journal-title":"Can. J. Diabetes"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1139\/apnm-2013-0449","article-title":"Exercise training improves aerobic capacity, muscle strength, and quality of life in renal transplant recipients","volume":"39","author":"Riess","year":"2014","journal-title":"Appl. Physiol. Nutr. Metab."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"3243","DOI":"10.1519\/JSC.0000000000003274","article-title":"Effects of Combined Resistance Plus Aerobic Training on Body Composition, Muscle Strength, Aerobic Capacity, and Renal Function in Kidney Transplantation Subjects","volume":"35","author":"Lima","year":"2021","journal-title":"J. Strength Cond. Res."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Picard, M., Tauveron, I., Magdasy, S., Benichou, T., Bagheri, R., Ugbolue, U.C., Navel, V., and Dutheil, F. (2021). Effect of exercise training on heart rate variability in type 2 diabetes mellitus patients: A systematic review and meta-analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0251863"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1007\/s10157-018-1633-8","article-title":"The efficacy of exercise training in kidney transplant recipients: A meta-analysis and systematic review","volume":"23","author":"Oguchi","year":"2019","journal-title":"Clin. Exp. Nephrol."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1093\/ndt\/gfy351","article-title":"Mortality and morbidity following exercise-based renal rehabilitation in patients with chronic kidney disease: The effect of programme completion and change in exercise capacity","volume":"34","author":"Greenwood","year":"2019","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"O\u2019Connor, E.M., Koufaki, P., Mercer, T.H., Lindup, H., Nugent, E., Goldsmith, D., Macdougall, I.C., and Greenwood, S.A. (2017). Long-term pulse wave velocity outcomes with aerobic and resistance training in kidney transplant recipients\u2014A pilot randomised controlled trial. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171063"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1249\/MSS.0000000000001886","article-title":"Physical Activity and Cardiovascular Risk among Kidney Transplant Patients","volume":"51","author":"Kang","year":"2019","journal-title":"Med. Sci. Sport. 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