#192 Intradialytic cognitive and physical training to enhance functional capacity: a randomized controlled trial

Abstract

Abstract Background and Aims Haemodialysis (HD) patients frequently experience cognitive and physical impairments due to various factors, including age, comorbidities, and the demanding nature of the treatment. This study explores the impact of a 12-week integrated cognitive and physical training program on the functional capacity of HD patients. Method A single-blind, randomized controlled trial was conducted with 44 HD patients. Participants were divided into an experimental (EXP) group (n = 22) and a control (CON) group (n = 22). The EXP group underwent 12 weeks of intradialytic cycling and tablet-based cognitive training three times a week, while the CON group received standard care (Fig. 1). Outcome measures were assessed pre- and post the 12-week intervention. Cognitive performance was evaluated using the Trail Making Tests A and B (TMTA and TMTB), while motor performance was assessed with the Timed Up and Go (TUG) test. Additionally, cognitive-motor interactions were examined using the TUG dual task test (TUG-dual). Results Results showed a significant effect of group*time interaction for TMTA test results (F(1,41) = 16.218, p < 0.001), TMTB test results (F(1,41) = 19.944, p < 0.001) favouring the EXP group. Additionally, a significant interaction was found for TUG test (F(1,40) = 8.854, p = 0.005) and for TUG-dual test (F(1,40) = 8.457, p = 0.006). Within the EXP group we observed significant improvements in cognitive function, as evidenced by decreased TMT completion times (TMTA: −3.6s, p = 0.006; TMTB: −14.0s, p < 0.001; TMTB–TMTA: −10.4s, p = 0.004). In contrast, the CON group experienced a significant decline in TMTA and TMTB (p < 0.009 and p < 0.026). Additionally, the EXP group exhibited enhanced mobility, with reduced TUG completion times (−0.8s, p < 0.001) and improved cognitive-motor performance in the TUG-dual (−1.0s, p < 0.001), while the CON group showed no significant changes (p > 0.05). Conclusion This study demonstrates that a 12-week combined cognitive and physical training program during HD sessions significantly enhances cognitive function and mobility in HD patients. These findings suggest that integrated non-pharmacological interventions can mitigate functional declines in this population and consequently improve their overall quality of life. Further research with larger samples and active control groups is warranted to confirm and expand upon these promising results.