Sleep and Training Aspects in Dialysis Fatigue - Exercise Intervention
Condition: Fatigue
MeSH terms: Fatigue
Study type: Interventional

Summary: 
      The purpose of the current study is to investigate whether changes in patients' sleep quality
      and quantity will be followed by improvements in parameters related to physical and mental
      fatigue in patients receiving hemodialysis therapy.

      More specific, the current project will investigate the effect of a 9 months intradialytic
      exercise training in aspects related to fatigue, quality of life and depression.
    

Detailed description: 
      Chronic renal disease is a "silent epidemic" affecting up to 10% of the population in the EU,
      USA, and Asian with some of the sufferers progressing into end-stage renal failure.

      Renal disease patients are characterized by progressively worsening muscle weakness and
      muscle atrophy due to both a metabolic and a disuse component collectively described as
      uremic myopathy. While various interventions in stable HD patients have helped these patients
      improve their functionality, they still have not proven enough to bring their muscle quality
      and quantity up to the levels of a healthy sedentary person. Moreover, patients present with
      sleep problems, neurological and quality of life issues, anxiety and/or symptoms of
      depression but most notably they complain of chronic fatigue and "lack of energy".

      Other factors that contribute to the excessive fatigue are a lack of restorative sleep,
      excess pre-dialysis weight, poor nutritional status, restless legs syndrome and the overall
      mental status of the patients. Evidently, of all of these factors can contribute to a
      self-exacerbating process, a vicious circle, of fatigue due to inactivity and further
      inactivity due to fatigue. This sensation of an enduring fatigue interferes with physical and
      social activities and feeds perceptions of increased restrictions and barriers, and leads to
      a significant reduction of physical activity and functional capacity, which in turn
      contributes to the increased cardiovascular risk and a high mortality rate among these
      patients.

      Rationale: The investigators hypothesize that by improving the patients fitness levels, it
      will lead in more energy during day and therefore less fatigue. Our mission is to help the HD
      patient to better cope with their sensation of fatigue.
    

Intervention name(s): Exercise; Usual Treatment
Intervention type(s): Other; Other
Intervention description(s): Training will include a 45-60 min aerobic training on a rehabilitation cycle ergometer (Monark Rehab Trainer 881E) in the supine position during dialysis session. The intensity will progress from 30-40% of the maximum exercise power to 60-70%.; The CON group received no intervention but the usual treatment
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Supportive Care
Keywords: Dialysis fatigue,; exercise intolerance,; muscle atrophy,; cachexia,; disability,; Sleep disorders; Depression; Mental Fatigue,; Cognitive function; Physical Fatigue