Effects of intradialytic exercise on the physical function, depression and quality of life for haemodialysis patients: a systematic review and meta-analysis of randomised controlled trials

Abstract

Aims and objectives: To determine the efficacy and safety of intradialytic exercises for haemodialysis patients, this study conducted a systematic review and meta-analysis of randomised controlled trials.

Background: Patients receiving haemodialysis have poor physical function, psychological status and quality of life than the general population. Exercise training may improve these parameters for haemodialysis patients.

Design: Systemic review was performed, and a meta-analysis was conducted.

Methods: Medline, PubMed, Cochrane Central Register of Controlled Trials, SPORTDiscus, Cumulative Index to Nursing and Allied Health Literature and Airiti Library were systematically searched for studies up to January 2015. In addition, the reference lists of eligible studies and relevant reviews were assessed.

Results: Seventeen studies with a total of 651 participants were included. Compared with no resistance exercise, nonexercise and walks at home, intradialytic exercises significantly improved the peak oxygen consumption (SMD = 0·50, 95% CI: 0·26-0·74), haemoglobin (SMD = 0·34, 95% CI: 0·13-0·55), depression (SMD = -0·80, 95% CI: -1·10 to -0·50) and physical component of the quality of life (SMD = 0·46, 95% CI: 0·20-0·73). Intradialytic exercises are safe with no adverse events. However, significant improvements were not observed in the albumin level and mental component of the quality of life.

Conclusions: The study results facilitate selecting intradialytic exercise that improves and provides safety with respect to the peak oxygen consumption, haemoglobin, depression and physical component of the quality of life. Furthermore, regular exercise should be considered a crucial therapeutic modality for patients undergoing haemodialysis.

Relevance to clinical practice: This study suggests that performing intradialytic exercises for 30 minutes per session three times a week for at least ≥8 weeks is beneficial. Regular exercise should be considered as a crucial therapeutic modality of managing patients undergoing haemodialysis, thus guiding in clinical practice.

Keywords: depression; exercise; intradialytic; physical function; quality of life.