Effectiveness of Resistance Exercise Therapy on Patients' Physiological Status during Hemodialysis: A Randomized Controlled Trial Effectiveness of Resistance Exercise Therapy on Patients' Physiological Status during Hemodialysis

Main Article Content

Ahmed ALkhaqani


Effectiveness, Hemodialysis, Exercise Therapy, Physiological Status



Background: Management disorder of vital signs remains a critical issue worldwide, particularly regarding hypertension in chronic renal disease (CRD), both of which are associated with a higher risk of cardiovascular (CV) and renal events. Physical inactivity resulting in poor exercise capacity is a common consequence of chronic kidney disease and is associated with increased mortality in the general population. Nursing management for patients undergoing hemodialysis requires an experienced nurse who understands the types of complications.

Objective: The present study aimed to evaluate the effectiveness of resistance exercise therapy on patients’ physiological status by utilizing a checklist of physiological parameters and comparing it with a control group.

Patients and Methods: The study was designed as a randomized controlled trial (RCT), using a double-blind technique, and it was conducted on patients divided into two groups (study and control groups). A total of 63 patients were included as follows: 32 patients for the study group and 31 patients in the control group. The patients were diagnosed with chronic kidney disease and were undergoing hemodialysis. The patients were randomly assigned to receive exercise therapy under the supervision of trained therapists during the second hour of the three routine hemodialysis treatments per week and under the supervision of the researcher. The study took place in Al-Najaf Al-Ashraf City/Al-Sadder Medical City and Al-Hakeem Hemodialysis Center.

Results: The study results indicated an improvement in the physiological status of the study group compared to the control group.

Conclusions: Exercise therapy effectively improves the physiological status of patients with chronic kidney disease undergoing hemodialysis.



Abstract 49 | Full text PDF Downloads 33


1. Alkhaqani AL, Abd Ali DK. Evaluate of the physical performance of patients undergoing hemodialysis. J Cardiovasc Dis Res. 2021;12(6):197–205.
2. Brasileiro TOZ, Prado AAO, Assis BB, Nogueira DA, Lima RS, Chaves ECL. Effects of prayer on the vital signs of patients with chronic kidney disease: Randomized controlled trial. Rev da Esc Enferm. 2017;51(3):1–9.
3. Villarroel M, Jorge J, Meredith D, Sutherland S, Pugh C, Tarassenko L. Non-contact vital-sign monitoring of patients undergoing haemodialysis treatment. Sci Rep [Internet]. 2020;10(1):1–21. Available from: https://doi.org/10.1038/s41598-020-75152-z
4. Ku E, Lee BJ, Wei J, Weir MR. Hypertension in CKD: Core Curriculum 2019. Am J Kidney Dis [Internet]. 2019;74(1):120–31. Available from: https://doi.org/10.1053/j.ajkd.2018.12.044
5. Li H, Xue J, Dai W, Liao X, Zhu P, Zhou Q, et al. Blood pressure variability and outcomes in end-stage renal disease patients on dialysis: A systematic review and meta-analysis. Kidney Blood Press Res. 2020;45(5):631–44.
6. Tasoulis A, Papazachou O, Dimopoulos S, Gerovasili V, Karatzanos E, Kyprianou T, et al. Effects of interval exercise training on respiratory drive in patients with chronic heart failure. Respir Med. 2010;104(10):1557–65.
7. Hostetter TH, Kochis DJ, Shaffer RN, Chertow G, Harmon WE, Klotman PE, et al. World kidney day 2020 campaign toolkit. J Am Soc Nephrol. 2020;22(3):397–8.
8. Reese PP, Cappola AR, Shults J, Townsend RR, Gadegbeku CA, Anderson C, et al. Nutrition in kidney disease. Am J Nephrol [Internet]. 2020;38(4):307–15. Available from: http://www.springer.com/series/7659
9. Stanifer JW, Muiru A, Jafar TH, Patel UD. Chronic kidney disease in low- and middle-income countries. Nephrol Dial Transplant. 2016;31(6):868–74.
10. National Kidney Foundation. National Kidney Foundation (NKF). Natl Kidney Found [Internet]. 2020;2(4):1–4. Available from: https://www.kidney.org/atoz/content/stayfit
11. Kiakalayeh AD, Mohammadi R, Pourfathollah AA, Siery Z, Davoudi-Kiakalayeh S. Alloimmunization in thalassemia patients: New insight for healthcare. Int J Prev Med. 2017;8:55–6.
12. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: Evaluation, classification, and stratification. Ann Intern Med. 2015;139(7):605.
13. Sullivan L. Power and sample size determination. Bost Univeristy Sch Public Heal. 2015;1–21.
14. Unger T, Borghi C, Charchar F, Khan NA, Poulter NR, Prabhakaran D, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020;75(6):1334–57.
15. London Medical College. Guidance for practices Guide to using pulse oximetry during Covid-19 pandemic Role of pulse oximetry during Covid-19 pandemic. 2021;1–6.
16. Ito O. Renal rehabilitation for patients with chronic kidney disease and dialysis. Japanese J Phys Med Rehabil Res. 2017;54(10):788–92.
17. Narva AS, Norton JM, Boulware LE. Educating patients about CKD: The path to self-management and patient-centered care. Clin J Am Soc Nephrol. 2016;11(4):694–703.
18. Alkhaqani A. Clinical characteristics and risk factors of chronic kidney disease among patients attending Al-Sadder Medical Hospital in Al-Najaf City. Turkish J Physiother Rehabil [Internet]. 2021;32(3):15117–27. Available from: https://turkjphysiotherrehabil.org/pub/pdf/321/32-1-1859.pdf
19. Asadzadeh A, Samad-Soltani T, Salahzadeh Z, Rezaei-Hachesu P. Effectiveness of virtual reality-based exercise therapy in rehabilitation: A scoping review. Informatics Med Unlocked [Internet]. 2021;100562. Available from: https://doi.org/10.1016/j.scitotenv.2019.135938
20. Alkhaqani AL, Ali DA. Improving physical performance through resistance exercise training on patients undergoing hemodialysis : A randomized clinical trial. Ann Rom Soc Cell Biol [Internet]. 2021;25(6):13639–53.
21. Thompson S, Wiebe N, Padwal RS, Gyenes G, Headley SAE, Radhakrishnan J, et al. Erratum: The effect of exercise on blood pressure in chronic kidney disease: A systematic review and meta-analysis of randomized controlled trials (PLoS ONE (2019) 14: 2 (e0211032) DOI: 10.1371/journal.pone.0211032). PLoS One. 2020;15(5):1–18.
22. Abd Elhalim EM, Aziz AG, Baligh E, Sahier El-Khashab, El-Sayed SH. Blood pressure response to intradialytic resisted exercise training in regular hemodialysis patients. Cairo Univ [Internet]. 2017;85(5):1789–94.
23. Woo JS, Derleth C, Stratton JR, Levy WC. The influence of age, gender, and training on exercise efficiency. J Am Coll Cardiol. 2006;47(5):1049–57.