Exercise during haemodialysis for patients

Dialysis Research

Structured exercise programme during haemodialysis for patients

A structured exercise programme during haemodialysis for patients with chronic kidney disease: clinical benefit and long-term adherence

Long-term studies regarding the effect of a structured physical exercise programme (SPEP) during haemodialysis (HD) assessing compliance and clinical benefit are scarce.

In conclusion, we have developed and tested a combined cardiovascular and resistance personalised exercise programme, which can be integrated into normal dialysis care.

Patients’ strength and endurance as well as QoL improved significantly over a 1-year period and adherence was close to 80% after 5 years, correcting for the forced dropouts related to transplantation or death.

To the best of our knowledge, this is the first time that an SPEP was successfully performed over half a decade.

Exercise training for patients with dialysis should be seen as a main strategy aside from pharmacological therapy and dialysis. It has to be titrated similarly as the dose of medication.

For any medication or intervention to be effective, the patient’s adherence is crucial. In add- ition, for widespread application, it must be recognised by the health insurance system. Our SPEP as described here fulfils these four criteria: Each patient receives a personally adapted training programme including the mode and dose.

The adherence is boosted by collective training and a stimulating environment created in the dialysis unit. Last but not least, the improvement of QoL of the patients contributes to the motivation for contin- ued or even intensified exercise training.

Support of this exercise training by a German health insurance company with €8/patient/training session covers the direct costs and also contributes to the patients’ motivation.

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