The effectiveness of intradialytic leg ergometry exercise for improving sedentary life style and fatigue among patients with chronic kidney disease: A randomized clinical trial

Background: Over the past three decades, research has been carried out on the effects of exercise on chronic kidney disease patients for improving their physical potential. Objectives: The purpose of this study is to evaluate the effect of intradialytic leg ergometry exercise for improving fatigue and daily physical activity levels among chronic kidney disease patients. Design: A quasi-experimental clinical trial. Setting: Two hemodialysis units in a medical center in northern Taiwan. Method: The leg ergometry exercise was performed within the first hour of each hemodialysis session for 30. min for 8 weeks. There were 36 subjects in the experimental group and 35 subjects in the control group who completed the study. Measurement on a fatigue scale and a physical activity log were done at the time of enrollment, and again on the fourth and eighth weeks. Result: Active subjects demonstrated significantly less fatigue and higher physical activity levels than those with a sedentary lifestyle at baseline. During the 8 weeks of intervention, subjects in both the active and sedentary groups reduced their fatigue levels significantly, with the exception of sedentary subjects in the control group. Only active subjects in the experimental group demonstrated an increase in activity levels. The 36 subjects performed 3456 leg ergometry exercise sessions with three early terminations (<.01%) among the sedentary subjects. Conclusions: Intradialytic leg ergometry is a safe exercise that is effective to reduce fatigue and improve physical fitness in already active chronic kidney disease patients and it also reduces fatigue in sedentary patients. Interventions to motivate sedentary patients to become active require further investigation. Implication for nursing practice: Exercise during hemodialysis does not cost patients extra time and is effective in reducing fatigue and increasing physical activity potential as demonstrated by our study; 30. min of intradialytic leg ergometer exercise can be considered as routine care while delivering hemodialysis.