This research aims to evaluate the reliability and reproducibility of muscle strength and activation measurement tools, including isokinetic dynamometry and surface electromyography, in patients with chronic kidney disease (CKD). Additionally, the study will assess the feasibility and potential benefits of an online therapeutic exercise program supervised by physiotherapists.

Patients with chronic kidney disease experience progressive muscle weakness and reduced physical capacity due to systemic inflammation, metabolic acidosis, and inactivity.

This two-phase observational and interventional study, conducted in collaboration with the ALCER Association (Badajoz and Cáceres, Spain), will:

1. Determine the test-retest reliability of muscle assessment tools (isokinetic dynamometer, surface electromyography, and handheld dynamometry).
2. Implement and evaluate an online therapeutic exercise program supervised by physiotherapists.

The project aims to provide valid and reliable protocols for neuromuscular assessment in CKD patients and explore the feasibility of remote therapeutic exercise.

Inclusion Criteria:

• ≥18 years old.
• Diagnosis of chronic kidney disease (hemodialysis, peritoneal dialysis, or kidney transplant).
• Member of ALCER Association (Badajoz or Cáceres).
• Medical clearance for physical testing/exercise.

Exclusion Criteria:

• Severe cognitive or communication impairment.
• Unstable cardiovascular or musculoskeletal conditions.
• Refusal to provide informed consent.