Effects of Intradialytic Exercise on Functional Capacity in Hemodialysis Patients: A Systematic Review

Monday, 30 July 2012

Hsiu-Mei Nian, BSN, RN1
Yueh-Yen Fang, PhD, RN2
Mei-Yin Yang, BSN, RN1
Mei-Hsia Chen, BSN, RN1
(1)Department of Nursing, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
(2)School of Nursing, Fooyin University, Kaohsiung, Taiwan

Learning Objective 1: The learner will be able to understand the effects of intradialytic exercise on functional capacity in hemodialytic patients.

Learning Objective 2: The learner will be able to describe the limitations of current evidence in intradialytic exercise studies.

Purpose: The purpose of this study was to evaluate the effects of intradialytic exercise (IDE) on functional capacity in hemodialysis patients.

Methods: A systematic review was conducted to respond the study purpose. Six English and two Chinese databases were used to search English and Chinese literature published up to April, 2011. Search terms used were ‘hemodialysis and exercise.’ Data were extracted by two researchers independently. Disagreement among data extraction was resolved by complete consensus between researchers. Study quality was evaluated by the Johns Hopkins Nursing Evidence-based practice Quality Rating Scale.

Results: Twelve studies that met the inclusion criteria were included for analysis. IDC did not influence systolic or diastolic pressure across studies. The effect of IDC on general physical component was also contradictory across studies. However, IDC did improve muscle strength and physical tolerance. Types of ICD given also vary. They included indoor and outdoor activities. The frequency of exercise each week was much consistent across studies. The IDCs were provided by either physical therapists or nurses.

Conclusion: There is still no consensus across studies on the effect of IDC. Variations in outcome measure across studies made the comparison of treatment effect difficult. There is also lack of sufficient literature under each exercise category. Future studies are encouraged to select valid measures that are feasible in communicating across studies.