Novel Approach to Intradialytic Progressive Resistance Exercise Training

Abstract

Physical activity levels are typically undesirably low in chronic kidney disease patients, especially in those undergoing haemodialysis, and particularly on dialysis days. Intradialytic exercise programmes could be a solution to this issue and have been reported to be safe and relatively easily implemented in dialysis clinics. Nevertheless, such implementation has been failing in part due to barriers such as the lack of funding, qualified personnel, equipment, and patient motivation. Intradialytic aerobic exercise has been the most used type of intervention in dialysis clinics. However, resistance exercise may be superior in eliciting potential benefits on indicators of muscle strength and mass. Yet, few intradialytic exercise programmes have focused on this type of intervention, and the ones which have report inconsistent benefits, diverging on prescribed exercise intensity, absent or subjective load progression, equipment availability, or exercise supervision. Commonly, intradialytic resistance exercise interventions use free weights, ankle cuffs, or elastic bands which hinder load progression and exercise intensity monitoring. Here, we introduce a recently developed intradialytic resistance exercise device and propose an accompanying innovative resistance exercise training protocol which aims to improve the quality of resistance exercise interventions within dialysis treatment sessions.

Intradialytic exercise in haemodialysis patients: applicability and effects on muscle function

“…In the dialysis centres where we carried out our study, therapy is provided solely in a prone or semi-recumbent position of the patient's body. These positions considerably reduce the scope of utilisable exercises for IDE and might be inappropriate for effective exercising due to the limitations in ranges and directions of extremity movements during IDE (Bogataj et al, 2020;Vogiatzaki et al, 2022;Cardoso et al, 2023). Moreover, evidence from a healthy population shows that a change of body position significantly affects the central physiological response to physical activity and neuromuscular activation during resistance exercises (Kramer et al, 1996;Maffiuletti & Lepers, 2003;Morini et al, 2008;Saetenbakken & Fimland, 2011;Villar et al, 2015).…”