ORIGINAL ARTICLE   Free access

European Journal of Physical and Rehabilitation Medicine 2021 December;57(6):994-1001

DOI: 10.23736/S1973-9087.21.06694-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Effects of exercise programs on physical function and activity levels in patients undergoing hemodialysis: a randomized controlled trial

Borja PEREZ-DOMINGUEZ ¹, Jose CASAÑA-GRANELL ¹ ✉, Rafael GARCIA-MASET ², Alicia GARCIA-TESTAL ², Erika MELENDEZ-OLIVA ³, Eva SEGURA-ORTI ³

¹ Department of Physiotherapy, University of Valencia, Valencia, Spain; ² Department of Nephrology, Hospital of Manises, Manises, Spain; ³ Department of Physiotherapy, University CEU Cardenal Herrera, Moncada, Spain

BACKGROUND: There are still many barriers when implementing exercise routines within daily dialysis care, even though benefits are well-known. Developing cost-effective strategies is necessary to overcome these barriers and include exercise as a complementary therapy in dialysis.
AIM: To compare several exercise programs on hemodialysis patient’s functional capacity and health-related quality of life.
DESIGN: This study was a 16-week follow-up, two-parallel group trial with balanced randomization.
SETTING: Participants in this study belonged to a private hospitalized care center.
POPULATION: Referred sample of 71 patients that suffered end-stage chronic kidney disease who underwent hemodialysis for at least 3 months and had a medical stable condition.
METHODS: Thirty-six participants performed for 16 weeks an intradialytic exercise program lead by the nursing staff of the hemodialysis unit and 35 a home-based program supervised by physical therapists of the hospital.
RESULTS: The main researcher and the data analyst were both blinded to participant allocation. There was a significant effect in time for both groups. Participants improved significantly in the Short Performance Physical Battery (SPPB), One-Leg Heel-Rise (OLHR) and 6 Minute-Walk Test (6MWT), and in the Physical Activity Scale for the Elderly (PASE) and Short Survey Form 36 (SF-36) questionnaires.
CONCLUSIONS: Nurse-led and home-based exercise interventions produce beneficial effects involving physical function, activity levels and health-related quality of life in patients undergoing hemodialysis.
CLINICAL REHABILITATION IMPACT: The study emphasizes the importance of exercise rehabilitation routines in fragile populations such as dialysis patients, and the potential to overcome barriers for its daily implementation.

KEY WORDS: Dialysis; Exercise; Rehabilitation