Implementing a resistance training programme for patients on short daily haemodialysis: A feasibility study.

Abstract

Kidney failure patients receiving haemodialysis experience protein-energy wasting, muscle mass lossand physical function impairment. Intradialytic exercise interventions seem to modify these features, but they are often not implemented as a clinical routine. To investigate the feasibility of implementing a supervised intradialytic resistance training programme as a clinical routine for patients receiving short daily haemodialysis. A prospective longitudinal study. Eighteen patients in a supervised intradialytic resistance training programme for 8 months. It consisted of a warm-up, lower- and upper-limb resistance exercisesand a cool-down. Patients performed the resistance training during the first half of haemodialysis, twice a week, supervised by exercise physiologists and physiotherapists. The feasibility was assessed by the total and partial adherences, the reasons for refusing or for not exercisingand the intradialytic complications. From a total of 953 potential exercise sessions, 759 were performed, with a 79.6% adherence rate. In the first 9 weeks, the adherence rate was 86.6% and the lowest rate was in the 19-27 weeks (73.5%). The main intradialytic complication during exercise sessions was hypotension (n = 31; 4.1%). The highest number of complications was reported during the first 9 weeks (n = 27; 9.1%). The main reasons for refusing or for not performing the intradialytic exercise sessions were clinical complications previous to exercise time (n = 63; 32.5%) and self-reported indisposition (n = 62; 32.0%). The intradialytic resistance training programme, supervised by exercise physiologists and physiotherapists, had very low complications, achieved a high long-term adherence rate and showed to be feasible as a clinical routine for patients receiving short daily haemodialysis.