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

Abstract

Background Kidney failure patients receiving haemodialysis experience protein‐energy wasting, muscle mass loss and physical function impairment. Intradialytic exercise interventions seem to modify these features, but they are often not implemented as a clinical routine. Objective To investigate the feasibility of implementing a supervised intradialytic resistance training programme as a clinical routine for patients receiving short daily haemodialysis. Design A prospective longitudinal study. Participants Eighteen patients in a supervised intradialytic resistance training programme for 8 months. Measurements It consisted of a warm‐up, lower‐ and upper‐limb resistance exercises and 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 exercising and the intradialytic complications. Results 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%). Conclusions 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.

Nurses' and medical doctors' attitudes towards exercise for people with chronic kidney disease in Denmark

“…Supervised training programmes may be a sufficient intervention to elevate the level of physical activity in people on dialysis (Wilkinson et al, 2020), as they spend many hours in the centres where their HD is performed. A recent feasibility study suggested resistance training as and intervention with a high long‐term adherence (Ribeiro et al, 2022). However, others may not wish to perform exercises in the nephrology centre if their travel distance is long or the time schedule does not fit into their personal life (Fang et al, 2020).…”

Intradialytic resistance training for short daily hemodialysis patients as part of the clinical routine: a quasi-experimental study

“…A detailed description of the intradialytic resistance training program may be consulted elsewhere ( Ribeiro et al, 2022c ). In brief, patients underwent two resistance training sessions per week.…”

“…Moreover, the total training load for each intradialytic resistance training session was calculated as the number of sets x number of repetitions x total weight (sum of dumbbell and ankle weights) ( Borresen and Lambert, 2009 ). Finally, the exercise session was interrupted in case of intradialytic complications such as hypotension and hypoglycemia (for more information, check Ribeiro et al, 2022c ).…”