Intradialytic exercise can improve physical function and health‐related quality of life (HRQoL) in hemodialysis (HD) patients, but is not implemented in routine clinical practice. Virtual reality (VR) exercise has resulted in benefits in non‐dialysis contexts, but implementation in HD patients has been limited. The aim of this review was to provide an overview of VR, present the results of a 12‐week intradialytic VR exercise intervention, and compare VR to conventional exercise. The secondary aim was to review the effect of VR exercise during the last 30 minutes of the HD session on hemodynamic stability. We conclude that VR exercise during HD is safe and can improve physical function and HRQoL, and can be performed safely toward the end of the HD session.
Background
Chronic kidney disease is closely related to a high risk of death and disability, poor physical performance, and frailty. The main objective of this research was to analyse how intradialytic administration of a non-immersive virtual reality (VR) exercise program would affect physical function and adherence to exercise in these patients.
Methods
A total of 56 individuals participated in two 12-week periods in a crossover randomised controlled trial. Each patient underwent a functional capacity evaluation before and after each study period. The functional tests administered included the 4-metre gait speed test, Short Physical Performance Battery (SPPB), timed up-and-go (TUG) test, one-legged stance test (OLST) for balance, sit-to-stand 10 (STS-10) and sit-to-stand 60 (STS-60) tests, and 6-minute walking test (6MWT). Adherence to the exercise program was also recorded. To assess the effect of VR exercise on the functional test outcomes over time, the patients were analysed using a 2-way repeated-measures ANOVA with time and treatment as the within-participant factors.
Results
By the end of the 12 weeks of exercise, compared to the control period, 33 participants showed significant change in physical function as measured through the 4-metre gait speed (0.14 m/s), SPPB (1.2 points), TUG (−1.7 seconds), OLST (7.1 seconds), STS-10 (−5.8 seconds), STS-60 (5.0 repetitions), and 6MWT (85.2 metres) with adherence rates exceeding 70%. There were no changes in the biochemical data or in the medications in the period of the study.
Conclusion
An intradialytic non-immersive VR exercise program improves patient physical function.
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