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Clinical Kidney Journal

Clinical Kidney Journal

Study Finds Preferred Exercises for Combating Fatigue in Dialysis Patients

Study Finds Preferred Exercises for Combating Fatigue in Dialysis Patients

Fatigue is one of the most common symptoms experienced by dialysis patients. In a 2020 study, researchers look at dialysis patients’ preferences for various exercise interventions in reducing fatigue.


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One of the most common symptoms that people on dialysis experience is fatigue. Studies show that fatigue ranges from 55% to 97% in patients on dialysis and is associated with increased mortality. Patients with an overwhelming sense of fatigue may be less inclined to engage in physical activity, which could lead to physical disability, frailty, and impaired quality of life.

In a 2020 study published in Clinical Kidney Journal, researchers look at dialysis patients’ preferences for different exercise interventions as a way to combat fatigue.*

What they did  

Researchers put together a workshop with five breakout group sessions for 24 patients on dialysis, of which 16 were on hemodialysis and eight on peritoneal dialysis (PD). They assigned eight caregivers to identify exercise interventions for these patients and deliver these interventions through a mobile phone application.

“Over the past decade, there has been substantial growth in the body of evidence indicating the effectiveness of mobile health technology solutions in the management of chronic conditions,” stated the study’s authors.

In total, 21 different types of exercises were noted, which were:

  • Walking in outdoor or natural settings
  • Walking on a treadmill
  • Mixed cardio and resistance exercise (lunges, star jumps, body-bearing exercises, resistance bands, and squats) 
  • Pilates
  • Cycling inside (stationary bike)
  • Cycling outdoors
  • Aqua aerobics
  • Gardening
  • Stretching
  • Yoga
  • Deep breathing
  • Swimming
  • Weights
  • Tai chi
  • Zumba
  • Meditation
  • Playing a musical instrument
  • Child-minding (babysitting)
  • Progressive muscle relaxation
  • Dancing
  • Running

What they found

They found that the top preferred exercises by dialysis patients were:

  • Walking in outdoor or natural settings
  • Walking on a treadmill
  • Mixed cardio and resistance exercise
  • Pilates

During the workshop discussions, they found that patients were motivated to choose or avoid certain types of exercises for the following reasons: 

  • Expecting tangible gains (e.g., strengthening and protecting the body from deterioration)
  • Overcoming physical limitations (e.g., combating fatigue)
  • Fear of risks (e.g., aggravating health)
  • Being realistic and achievable (e.g., affordable and feasible)
  • Enhancing motivation and interest (e.g., finding incentives)
  • Ensuring the usability of the mobile application (e.g., simple and easy to use)

Researchers also found that participants perceived a mobile application with simple instructions and a user-friendly interface to be an acceptable and practical way to deliver exercise interventions.

What it means

In general, patients on dialysis are interested and motivated to incorporate physical activity in their lifestyle to combat dialysis-related fatigue. It’s important to understand, however, the identified reasons they may choose, or avoid, certain types of exercise when designing an individualized physical activity plan for each patient. 

“These factors need to be considered in identifying and developing exercise interventions to help maximize acceptability, uptake and sustainability, which in turn may help to enhance overall patient outcomes,” the study’s authors stated.

*Ju, A., Scholes-Robertson, N., Johnson, D. W., Cho, Y., et al. (2020, Feb. 4). Patient-led identification and prioritization of exercise interventions for fatigue on dialysis: a workshop report. Clinical Kidney Journal. https://academic.oup.com/ckj/advance-article/doi/10.1093/ckj/sfz200/5722188

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