Intradialytic Rehabilitation and Functional Independence in Hemodialysis Patients

Effects of Intradialytic Dynamic Lumbar Stabilization Exercises and Inspiratory Muscle Training on Functional Independence in Patients Undergoing Maintenance Hemodialysis

This study evaluated whether a rehabilitation program performed during hemodialysis sessions could improve daily functioning and mobility in adults receiving maintenance hemodialysis. Participants took part in either exercise-based rehabilitation, breathing muscle training, or usual care. The study compared changes in functional independence and mobility before and after the rehabilitation period.

This academic clinical study was conducted in two dialysis centers in Istanbul between June 2016 and March 2017. Adults undergoing maintenance hemodialysis were allocated to one of three groups: dynamic lumbar stabilization exercises, inspiratory muscle training, or a control group receiving routine nephrological care.

Participants in the intervention groups completed a supervised intradialytic rehabilitation program three times per week for 10 weeks. Functional independence and mobility-related performance were assessed at baseline and after completion of the intervention using validated functional assessment measures. The study was conducted as part of a doctoral thesis and is being retrospectively registered for transparency.

Inclusion Criteria:

• Adults aged 25 to 45 years.
• Diagnosis of chronic kidney disease undergoing maintenance hemodialysis.
• Receiving hemodialysis for at least 6 months.
• Hemodialysis schedule of three sessions per week, four hours per session.
• Clinically stable at the time of enrollment.
• Ability to participate in exercise and functional assessments.
• Provided written informed consent.

Exclusion Criteria:

• Acute medical conditions or unstable cardiovascular disease.
• Severe musculoskeletal, neurological, or orthopedic disorders limiting exercise participation.
• Severe cognitive impairment or inability to follow instructions.
• Uncontrolled hypertension or other conditions contraindicating exercise.
• Participation in another structured exercise or rehabilitation program during the study period.