Abstract
PURPOSE: Patients undergoing dialysis have low levels of physical activity compared to their age matched healthy sedentary adults (Kidney International, Vol. 57 (2000), 2564-2570). It is observed that there is continuous decline in physical function and associated increased mortality and morbidity, in these patients. In 2016, the American College of Sports Medicine stated that intradialytic exercise is medicine for haemodialysis patients. Exercise during haemodialysis has been shown to benefit muscle strength and bone demineralization, reducing cardiovascular risk dialysis related symptoms and improving physical fitness and HRQOL. Exercise during haemodialysis has higher adherence compared to out-patient exercise in a rehab center. Therefore, this study was conducted to see the effects of intra-dialytic exercises on fitness and quality of life. METHODS: Before enrolling the patients (N=50), a general history was taken. Physical fitness was assessed by 6-minute walk test with telemetry ECG monitoring and health-related quality of life assessment was done using DSI Scale (Dialysis symptom index). Patients were given breathing exercises, active movements of extremities, strengthening and specific therapies for other issues during each dialysis session (2-3 days/week). After completion of the dialysis, patients performed aerobic exercise on a stationary bicycle. At the end of 12 sessions, the 6-minute walk test (N=17) and DSI questionnaire (N=25) were repeated. RESULTS: There was an average 40 meters (13.88%) improvement in 6-minute walk test distance after 12 sessions of rehabilitation (p<0.0001, t=5.935). The number of symptoms patients suffered related to dialysis went down by 2.44 points (21.40%) after rehabilitation (p=0.0015, t=3.584). The Dialysis symptom Index score improved by 10 points (27.80%) (p<0.0001, t=4.798). CONCLUSIONS: An intradialytic aerobic and strengthening exercise program showed significant health benefits by reducing dialysis related symptoms, improved physical fitness and improved health related quality of life.
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