Despite the benefits of physical exercises among children with chronic illness, the children avoid to engage in different physical activities because their parent and the child also were faired to happen any complication to child. The lack of activity and sedentary life style among these children result in reduced quality of life in addition to behavioral and social problems and finally become independent in most of activities of daily living. Therefore, the primary aim of this study will to practice and teach the children exercise programs in order to improve the quality of life and reduce stress in children undergoing hemodialysis. Therefore aim of this study is to: Determine the effect of exercise program on quality of life and stress in children undergoing hemodialysis.

• The researcher will go to hospital and will take all children that present in hemodialysis unit, then will make random assignment of children to study or control group .The control group will receive routine care while the study group will receive exercise program.
• The exercise program will conduct three days per week giving an interval of 24 hours between sessions. In the first hour the child not make any activity, then first 20 min from second hour of hemodialysis the child will receive stretching exercise, first 20 min from third hour the child will receive range of motion exercise finally first 20 min from forth hour the child will practice isometric exercise.
• This procedure will continue for 2 months and the end of time the research will make posttest for both groups. The intensity for resistance training will determined individually. Depending up on the child exercise tolerance, each set will performed 10 gradually increase to 15 repetitions.

Inclusion Criteria:

• Children aged from 6-18years with chronic renal failure.

  • All children are stable on dialysis for 2 months (Blood pressure under medical control and stable blood sugar).
  • All children are free from lower extremity graft and any lower limb pathology.
  • Children do not take exercise in 6 months before treatment.
  • Willing to participate in the study and attend the exercise schedule.
  • Children able to follow verbal commands.

Exclusion Criteria:

• Children with physical disabilities.
• Children on tranquilizers or sedative medications.
• Children with a femoral dialysis catheter& internal jugular vein catheter