Short-term Modified Tai Chi Exercise Improves Quality Of Life In Hemodialysis Patients

Abstract

INTRODUCTION: Benefits of intradialytic exercise performed during outpatient hemodialysis (HD) therapy sessions have been demonstrated in End-Stage Renal Disease patients in previous studies. However, there is little evidence on the benefits of quality of life (QOL) as maintenance HD patients often show substantial reductions in QOL. Most studies used stationary cycling, strength and resistance training as modes of exercise. This is the first study that implemented an intradialytic mind-body exercise which has the advantages of requiring no equipment and little training or supervision. PURPOSE: To test the feasibility and to determine the impact of an 8-week intradialytic modified Tai Chi (MTC) exercise intervention on QOL in HD patients. METHODS: Maintenance HD patients (n=21, 9 females, 52.2±12.1 yr) were recruited from a local dialysis center and screened based on clinical criteria. All participants were encouraged to perform MTC for 1 hr within the first 2 hours of each 4-hr HD session, 3×/wk. The MTC was designed based on traditional Tai Chi for a patient to perform while sitting in a recliner with one arm connected to the dialysis machine. QOL was assessed at baseline, 4 wk, and 8 wk using the SF-36® scale. Time effects were assessed with repeated measures ANOVA. RESULTS: Intradialytic MTC never caused any interference or inconvenience to hemodialysis treatment, and no adverse effect was observed or reported. Participants needed less than 3 hr to learn the exercise, and were then able to perform the exercise with complete independence following a written instruction. Three participants dropped out due to loss of interest or change of health condition unrelated to the current exercise intervention. MTC significantly improved mental health (P<0.001) after 4 wk and sustained to 8 wk. After 8 wk, significant improvements were observed in physical function (P=0.023), role-physical (P<0.001), vitality (P=0.013), and role-emotional (P<0.001), but no effect on bodily pain, general health, or social functioning. CONCLUSION: MTC may be a feasible, low-cost, and effective exercise to improve QOL in maintenance HD patients. Our preliminary observations underscore the need for further long-term studies using larger sample size to establish the benefits of MTC in HD patients.