Sustaining a Hemodialysis Exercise Program: A Review

Abstract

This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980-February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand-searched for further publications. Criteria for inclusion included full-text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis.

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

“…Social support is a multidimensional concept that includes emotional (communication of empathy and esteem) and instrumental support (offering assistance and information) (27). Previous publications have emphasized the technical role of the exercise specialist in IDE (25,26), consistent with instrumental support. However, it was the emotional interpretation of this technical support that seemed critical to enhancing perceptions of the intervention's effectiveness and facilitated high acceptability of IDE.…”

“…Although the importance of exercise professional support in sustaining an IDE program has been recognized (25,26), how support functions to enhance the effectiveness of IDE and what may be required from those delivering IDE are unknown. We identified the support of the kinesiologist as a key component of IDE implementation.…”

Factors related to fatigue in Chinese patients with end-stage renal disease receiving maintenance hemodialysis: a multi-center cross-sectional study

“…The staff can be incorporated into the exercise intervention program with MHD patients, to develop a truly individualized physical activity program. 54 In the present study, laboratory parameters were explored as predictors of fatigue. We found that fatigue was negatively correlated with Scr concentrations and positively correlated with Kt/V level rather than with other laboratory variables.…”

Effect of home-based exercise on functional ability of hemodialysis patients: a systematic review and meta-analysis

“…Despite the significant impact of exercise on hemodialysis patients, these patients are inactive and have reduced physical activity and function (18,19). Unawareness of the benefits of exercise, fear of injury, experience of disability, low power to exercise, lack of motivation, lack of sports facilities and lack of financial support are some of the reasons which decrease levels of mobility and exercise in hemodialysis patients (20)(21)(22)(23). Various problems caused by physical inactivity have some effects on various aspects of lives of patients undergoing hemodialysis.…”