Effects of Intradialytic Exercise on Dialytic Parameters, Health-Related Quality of Life, and Depression Status in Hemodialysis Patients: A Randomized Controlled Trial.

Chia-Huei Lin,Shang-Lin Chiang,Yi-Ling Lee,Yu-Juei Hsu,Chueh-Ho Lin,Meei-Shyuan Lee,Pi-Hsiu Hsu

doi:10.3390/ijerph18179205

Abstract

Exercise is fundamentally important in managing chronic diseases and improving health-related quality of life (HRQL). However, whether intradialytic exercise is safe through assessment of changes in dialytic parameters and has a positive impact on HRQL and depression status of hemodialysis patients requires further research with diverse racial and cultural populations to identify. This study aimed to evaluate the effects of intradialytic exercise on dialytic parameters, HRQL, and depression status in hemodialysis patients. A randomized controlled trial was conducted at a medical center in Northern Taiwan. Sixty-four hemodialysis patients were recruited using stratified random sampling. Participants were randomized into an experimental group (EG, n = 32) or a control group (CG, n = 32). The EG received a 12-week intradialytic exercise program while the CG maintained their usual lifestyles. Dialytic parameters, HRQL, and depression status were collected at baseline and at 12 weeks. The results indicated no differences in the dialytic parameters from the baseline between both groups. However, the EG had increased HRQL (ß = 22.6, p < 0.001) and reduced depression status (ß = −7.5, p = 0.02) at 12 weeks compared to the CG. Therefore, a 12-week intradialytic exercise regime is safe and effective in improving HRQL and reducing depression status for hemodialysis patients.

Highlights

The results of the current study demonstrated that a 12-week intradialytic exercise intervention is effective in improving health-related quality of life (HRQL) and decreasing depression status among hemodialysis patients, but presents no differences in the dialytic parameters, indicating the intradialytic exercise regime is safe for hemodialysis patients
12-week, moderate-intensity intradialytic exercise program had no additional benefit in cardiometabolic factors, our study results add to the literature illustrating that intradialytic exercise has a positive impact on HRQL and depression status without remarkable adverse events in hemodialysis patients, highlighting its clinical benefit when it is provided in combination with hemodialysis treatments in ESRD patients
Our current study evaluated the effects of intradialytic exercise on the changes of glomerular filtration rate among hemodialysis patients, confirming the safety of a 12-week, moderate intradialytic exercise for hemodialysis patients

Summary

Introduction

ESRD patients on hemodialysis maintenance with associated multi-comorbidities (i.e., cardiovascular disease, renal bone disease, and anemia), experience an impaired health-related quality of life (HRQL) [2,3], and increased depression status due to the high burden of somatic symptoms and psychological distress [2,4,5]. Both HRQL and depression status has been reported to be associated with

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