Finding the effect of core stability exercises with breathing exercises on Activities of daily living (ADLs), fatigue level and balance in maintenance hemodialysis patients.

Sixty patients will be randomly assigned into two equal groups, the experimental (EX) group and the control group (CON). The participants' age will be 50-65 years and undergo hemodialysis. The Ex-group will attend three sessions/week of core stability exercise training (CSE) combined with Deep Breathing (25:30-min) for 8 weeks, the CON will attend 3 sessions/week of Deep Breathing (15-min) for 8 weeks. All the patients received only routine hemodialysis department care.

Inclusion Criteria:

• Adults ranging from 55- 70 years old of both genders.
• Diagnosed as maintenance hemodialysis for at least 6 months or more.
• Free from mental illness, neuromuscular disorders, and serious lung problems and able to implement the interventional exercise.

Exclusion Criteria:

• Obesity (BMI ≥ 30 kg/m2)
• Orthopeadics or neurological problems that interferes with training.
• History of pulmonary problems (COPD, pneumonia)
• History of Myocardial infarction and/or cardiothoracic surgery
• Unstable medical status
• Dementia that interferes with the ability to follow instructions.
• History Chronic Fatigue Syndrome (CFS).