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Abstract
Background: Exercise is known to improve mental and physical functioning and to improve quality of life. The obstacles faced by individuals with chronic kidney disease on maintenance haemodialysis include increased levels of fatigue, decreased motivation, and the inability to schedule exercise around daily activities and dialysis schedules.
Aim:This pilot study was undertaken to determine the feasibility and potential efficacy of an individually-tailored exercise program for in-centre haemodialysis patients.
Method: A 16 week program was designed and evaluated in relation to changes in physical capacity, the extent of exercise undertaken, and quality of life indicators.
Results and Conclusion: The resultant recommendations regarding the level of motivational support, the time and physical requirements in implementing an exercise program will provide useful information for others embarking on similar studies.
Key Words
haemodialysis, exercise, renal, chronic kidney disease, nursing
Introduction
Haemodialysis (HD) patients' quality of life (QoL) is significantly impaired in comparison to the healthy population, and those who have received a renal transplant (Cheema & Singh, 2005). This is often attributed to high levels of fatigue, which encompasses physical and mental exhaustion, reduced motivation and reduced activity (McCann & Boore, 2000 & Kutner, 2007). Despite patients commonly having poor exercise tolerance, some form of exercise is believed to improve physical and mental functioning in dialysis patients and thereby enhance their QoL (Moug et al, 2003; Painter et al 2004; Bennett et al, 2007).
The physiological benefits and the QoL impact of intra-dialytic exercise are still a matter of debate. Some authors suggest no changes result after commencing an intra-dialytic exercise program (Parsons et al, 2004) whilst others note improvements (Cheema & Singh, 2005; Painter et al, 2000). At a minimum, it appears that intradialytic exercise may provide a supportive supervised environment where additional encouragement and counselling are available (Painter et al, 2000) . Unfortunately there are difficulties involved in implementing and sustaining exercise programs (White & Grenyer, 2006), with the greatest challenges pertaining to the maintenance of an 'exercise culture' (Bennett et al, 2007). It is also difficult to maintain patient motivation in the longer term, given the known link between fatigue, motivation and depression (Kutner, 2007; Moisted et al., 2004).
It has been demonstrated that intra-dialytic exercise can be effective in people with chronic...