Randomized Controlled Trial of Intradialytic Cognitive and Physical Training to Enhance Functional Capacity

Abstract

IntroductionHemodialysis (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. MethodsA single-blind, randomized controlled trial was conducted with 44 HD patients. Participants were divided into an experimental (EXP) group that received a combined intervention of intradialytic cycling and cognitive training, and a control (CON) group receiving standard HD treatment. The Trail Making Test (TMT), Timed Up and Go (TUG) test, and TUG dual task test (TUG-dual) were conducted before and after the intervention. ResultsThe EXP group demonstrated 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. 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. ConclusionThis 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 interventions can mitigate functional declines in this population and 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.