Background People with chronic renal failure (CRF) show decreased respiratory fitness and poor quality of life (QOL). Exercise during hemodialysis has been suggested to improve the cardio‐respiratory fitness. However, results of effects of respiratory muscle (RM) training on respiratory fitness and QOL are inconsistent. In addition, very few studies explored the association between inspiratory muscle (IM) training and sensation of breathlessness. Objectives To examine the effects of IM training in hemodialysis patients on respiratory fitness QOL and breathlessness. Method A randomized control trial with 50 CRF, who underwent hemodialysis (25 individuals in each group; IM training and sham group) was designed. Pulmonary function, RM strength, QOL (measured by Kidney Disease Quality of Life‐36), and sensation of breathlessness were measured before and after an 8‐week intervention. Results Compared to the sham group, the IM strength increased in the intervention group after an 8‐week program (Δ25.92 ± 8.73 cmH2O, p = 0.005). Significantly increased IM and forced vital capacity values in training groups was observed after an 8‐week intervention (Δ12.44 ± 3.07 cmH2O and Δ0.097 ± 0.046 L, respectively), but not the sham group. Neither, the training group, nor the sham group were significantly different in the QOL. However, feeling of shortness of breath improved after the training program among inspiratory muscle training group, but not the sham group. Conclusion IM training during hemodialysis could lead to an improvement of respiratory fitness and reduce breathlessness in people with CRF who are receiving hemodialysis. However, QOL was not different after the training program. The study suggests that after 8‐week intervention program, IM training (loading exercise) could improve IM strength, pulmonary function without any complications during the intervention program within 1–2 h.

Muscle wasting and activity limitations have been reported in patients undergoing hemodialysis, and these ultimately lead to poor quality of life. We aimed to develop a respiratory training device and determine its effectiveness in improving cardiorespiratory performance and dyspnea scores in patients undergoing hemodialysis. Twenty-five (25) patients aged ≥ 35 yr who underwent hemodialysis thrice a week were recruited in this quasi-experimental study. A respiratory training device was developed, and its effectiveness was examined. Participants performed a total of 45 inspirations (three sets of 15 inspirations) at 40% of the maximal inspiratory pressure (MIP) thrice a week. Respiratory muscle strength, 6-min walk distance, and dyspnea score were assessed before and after the 8-wk intervention program. Paired t-tests were used to compare pre- and post-intervention values. Of the 25 patients enrolled, 22 (88%) completed the 8-wk program. Significant improvements in inspiratory muscle strength (∆14.23 ± 3.41 cmH2O), 6-min walk distance (∆20.09 ± 9.10 m), and rate of dyspnea (∆0.50 ± 0.16 scores) were observed after the 8-wk intervention. An 8-wk training program using a respiratory device prototype can effectively improve cardiorespiratory performance in terms of increase in inspiratory muscle strength, improved functional capacity, and dyspnea relief in patients undergoing hemodialysis.

Background: Muscle wasting and limitation in physical activity have been reported in patients with hemodialysis; this leads to poor quality of life at the end. Objective: To develop the respiratory training device and to determine the efficiency of the prototype on respiratory muscle strength, functional capacity and dyspnea perception in hemodialysis patients. Design, setting and participants: the development of respiratory device was created and then effects of respiratory device were examined in hemodialysis patients. A total of 25 patients with quasi experimental study was recruited in the present study with aged ≥ 35 years old. All participants had a history of hemodialysis 3 days per week. Outcome measurements and statistical analysis: The protocol was conducted 15 inhales, three set per day with 40% of maximal inspiratory pressure; totally 45 inhales. The participants were asked to perform for three times per week during on hemodialysis. Respiratory muscle strength, the 6minute walk test and rate of dyspnea scores were assessed before and after 8-week intervention program. Paired t-tests was used to compare between initial values and follow-up values in respiratory prototype. Results: Of 25 patients at initially was enrolled, 22 individuals (88%) completed in the 8-week program. Significant improve in inspiratory muscle strength, 6minite walk distance and rate of dyspnea was observed after 8-week intervention (12.44± 3.55 cmH2O, 24.78 ± 8.89 meters, and 0.50 ± 0.19, respectively). Conclusion: Using porotype of respiratory device can effectively improve cardiorespiratory performance which is marked by increasing inspiratory muscle functional capacity and rate of dyspnea in hemodialysis patients after 8-week training program.