Contribution of Per Dialytic Physical Activity in Chronic Dialysis Patients

Contribution of Physical Activity Per Dialytic in Chronic Dialysis Patients

Dialysis patients have reduced walking capacity and an important risk of high blood pressure. These complications are associated with a decline in quality of life and increased mortality. The hypothesis of the study is to show that physical activity during the dialysis session in dialyzed patients has a benefit on quality of life, as well as on muscle, cardiovascular and dialysis parameters.

Dialysis patients have reduced aerobic capacity, walking ability, and an increased risk of hypertension. These complications are associated with a decline in quality of life and increased mortality.

Since asthenia is too intense after the dialysis session, patients are encouraged to perform physical activity during dialysis sessions. Some studies have shown that physical activity during dialysis can have benefits on quality of life and improve muscle parameters, but without this being clinically significant. Other studies show no benefit. The objective of the study is to explore the benefits of physical activity on quality of life, muscle parameters, and biological and dialysis parameters in a cohort of compliant hemodialysis patients.

Inclusion Criteria:

• Adults aged 18 and over, undergoing chronic hemodialysis at CHI André Grégoire for more than 3 months.
• Consent to participate in physical activity during dialysis sessions.
• Written informed consent.
• Affiliation with a social security system

Exclusion Criteria:

• Lower limb amputation without a prosthesis.
• Non-healed foot wounds.
• Hemoglobin < 8 g/dl.
• Patient refusal to participate.
• Severe respiratory (oxygen dependence) or cardiac disease (NYHA class 3 or 4, LVEF < 30%).
• Advanced dementia or psychiatric illness impeding cooperation, or refusal to consent.
• Non-French speaking patients unable to understand the study.
• Patients under guardianship.
• Advanced osteoarthritis, recent hip or knee prosthesis (< 3 months).
• Hypotension (BP < 90/40 mmHg) or hypertension (BP > 180/110 mmHg).
• Fever (temperature >= 38°C).
• Hypoglycemia (fingerstick glucose < 0.8 g/l) in diabetic patients.
• Dyspnea or desaturation in ambient air < 95%.
• COVID-19 symptoms within the last 21 days, positive PCR test, unable to pedal.
• Chest pain or unstable angina.
• Muscle or joint contraindications to the pedal exerciser as assessed by a physiotherapist