Authors (including presenting author) :
Lo CW (1), Cheng P(1), Lam PL(1)
Affiliation :
(1) Department of Physiotherapy, Queen Mary Hospital
Keyword 1: :
Renal Hemodialysis
Keyword 2: :
Intradialytic
Keyword 4: :
Hemodialysis
Keyword 5: :
Ergometric exercises
Introduction :
Intradialytic exercise is increasingly recognized as a beneficial intervention during hemodialysis (HD). While existing evidence supports improvements in physical function and psychosocial outcomes, the feasibility and acceptability of implementing such programs in local clinical settings remain underexplored. Consequently, a pilot intradialytic leg ergometric exercise program was implemented in the HD unit at Queen Mary Hospital in November 2024.
Objectives :
1) To evaluate feasibility and acceptability of the exercise program in a HD unit
2) To review the effects of the program on the strength, functional capacity and quality of life
Methodology :
The program was conducted from 11 November 2024 to 11 April 2025 and comprised 30 minute intradialytic cycling sessions delivered twice weekly over 12 weeks (24 sessions). Eligible participants were adults (≥18 years) who had been receiving hemodialysis for 3–5 years and maintained a hemoglobin level of ≥7 g/dL. The presence of lower limb access sites, unstable medical conditions, or temporary hemodialysis were excluded. Outcome measures included handgrip strength, the 30 second sit to stand test, the 6 minute walk test, and the KDQOL 36 questionnaire, which were assessed at baseline, the 12th session, and the 24th session. Statistical analyses were performed using SPSS v26.
Result & Outcome :
Out of the 10 patients enrolled, 1 dropped out with participation rate of 90%. The remaining 9 participants completed with no adverse effects, demonstrating strong feasibility and acceptability. Patients ranged from 40 - 84 years old (Mean age of 67.2) with the gender distribution as 44.4% male and 55.6% female. Improvements were observed in physical performance, including handgrip strength (18.6 to 21.0 kgf, p = 0.062), 30-second Sit-to-Stand repetitions (10.9 to 12.1, p = 0.21), and 6-Minute Walk Test (318 to 339 meters, p = 0.426). Quality of life scores remained stable overall, with some improvement noted in effects of kidney disease (p = 0.88), while declines were observed in burden of kidney disease burden and the SF-12 mental composite score (p = 0.35; p = 0.74). Intradialytic leg ergometric exercise is both feasible and safe for dialysis patients, showing improving trends in physical fitness and modest quality of life gains. However, challenges remain regarding mental health and perceived disease burden. Future programs should implement targeted strategies to address sarcopenia and support psychosocial wellbeing.
