Chronic Kidney Disease (Stages 4 and 5), Hemodialysis
Conditions
Keywords
intradialytic exercise, rehabilitation, inspiratory muscle training, core stabilization, functional independence, mobility
Brief summary
This study evaluated whether a rehabilitation program performed during hemodialysis sessions could improve daily functioning and mobility in adults receiving maintenance hemodialysis. Participants took part in either exercise-based rehabilitation, breathing muscle training, or usual care. The study compared changes in functional independence and mobility before and after the rehabilitation period.
Detailed description
This academic clinical study was conducted in two dialysis centers in Istanbul between June 2016 and March 2017. Adults undergoing maintenance hemodialysis were allocated to one of three groups: dynamic lumbar stabilization exercises, inspiratory muscle training, or a control group receiving routine nephrological care. Participants in the intervention groups completed a supervised intradialytic rehabilitation program three times per week for 10 weeks. Functional independence and mobility-related performance were assessed at baseline and after completion of the intervention using validated functional assessment measures. The study was conducted as part of a doctoral thesis and is being retrospectively registered for transparency.
Interventions
BEHAVIORALDynamic Lumbar Stabilization Exercises
A structured intradialytic exercise program focusing on trunk stabilization and neuromuscular control, performed under supervision during hemodialysis sessions.
BEHAVIORALRespiratory Muscle Training
Respiratory muscle training performed during hemodialysis using threshold-based breathing exercises under supervision.
Sponsors
Bandırma Onyedi Eylül University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessments were performed by a physiotherapist who was blinded to group allocation.
Intervention model description
Participants were allocated to one of three parallel groups: dynamic lumbar stabilization exercises, inspiratory muscle training, and a control group receiving usual care.
Eligibility
Sex/Gender
ALL
Age
25 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 25 to 45 years. * Diagnosis of chronic kidney disease undergoing maintenance hemodialysis. * Receiving hemodialysis for at least 6 months. * Hemodialysis schedule of three sessions per week, four hours per session. * Clinically stable at the time of enrollment. * Ability to participate in exercise and functional assessments. * Provided written informed consent.
Exclusion criteria
* Acute medical conditions or unstable cardiovascular disease. * Severe musculoskeletal, neurological, or orthopedic disorders limiting exercise participation. * Severe cognitive impairment or inability to follow instructions. * Uncontrolled hypertension or other conditions contraindicating exercise. * Participation in another structured exercise or rehabilitation program during the study period.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Six-Minute Walk Test | Baseline and after 10 weeks | Functional exercise capacity assessed as the distance walked in six minutes, measured according to standardized procedures. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timed Up and Go Test (TUG) | Baseline and after 10 weeks | Functional mobility assessed by the time required to stand up from a chair, walk three meters, turn, walk back, and sit down. |
| Five Times Sit-to-Stand Test (5STS) | Baseline and after 10 weeks | Lower extremity functional performance assessed as the time required to complete five consecutive sit-to-stand movements. |
| Maximal Inspiratory Pressure (MIP) | Baseline and after 10 weeks | Inspiratory muscle strength measured as maximal inspiratory pressure using standardized respiratory pressure measurement techniques. |
| Maximal Expiratory Pressure (MEP) | Baseline and after 10 weeks | Expiratory muscle strength measured as maximal expiratory pressure using standardized respiratory pressure measurement techniques. |
| Forced Vital Capacity (FVC) | Baseline and after 10 weeks | Pulmonary function assessed as forced vital capacity measured by spirometry according to standard guidelines. |
| Forced Expiratory Volume in 1 Second (FEV1) | Baseline and after 10 weeks | Pulmonary function assessed as forced expiratory volume in one second measured by spirometry according to standard guidelines. |
Contacts
PRINCIPAL_INVESTIGATORSerpil Çolak, PT, PhD
Bandırma Onyedi Eylül University
STUDY_DIRECTORCandan Z Algun, PT, PhD
Medipol University
STUDY_CHAIRGürkan Yurteri, MD
Rentek Diyaliz Merkezi
Outcome results
None listed