1000 Section - Hospital-based extra-dialytic exercise on physical activity level and sleep quality in end-stage renal disease patients: a randomized controlled trial

To examine whether hospital-based extra-dialytic exercise therapy improves physical activity and sleep quality in patients with end-stage renal disease under hemodialysis.

Design: Twenty-two end-stage renal disease patients undergoing hemodialysis for more than a month participated this study. The participants were randomly assigned to either hospital-based exercise group(n=10) or control group(n=12). The exercise group received exercise therapy twice a week for 8 weeks, consisting of 60-minute sessions before their hemodialysis. Each exercise therapy included stretching, muscle strengthening and aerobic exercise tailored to each patient’s physical condition. The control group received education of home exercise program only once. All participants were asked to wear a wrist actigraphy(ActiGraph GT9X LinkⓇ, ActiGraph) for 7-days 24-hour periods consecutively, at three different time points: initial, after 4 weeks, and after 8 weeks. The device recorded data on physical activity level and quality of sleep.

Results: Two groups showed no significant difference in baseline demographic, clinical characteristic and hemodialysis profile data. Repeated measures analysis of variance indicated that there were no significant changes observed in the level of physical activity (moderate to vigorous physical activity, 155.28vs.174.69, p=0.912; step counts, 9884vs.10497, p=0.676) or in the quality of sleep (sleep efficiency, 88.00vs.85.63, p=0.808; sleep fragmentation index, 27.30vs.28.79, p=0.996) after 8 weeks of treatment. Additionally, no significant differences were found in quality of life or skeletal muscle mass (skeletal mass index, 6.84vs.7.45, p=0.312). However, there was a significant improvement of hand grip strength (24.42vs.29.71, p< 0.001) in the exercise group (Table 1, 2).

Conclusion: After 8 weeks of hospital-based exercise therapy, there was no difference in physical activity level and sleep quality between the exercise group and the control group except for hand grip strength. Further study considering exercise intensity, duration, and frequency in end-stage renal disease patients is needed.