Intradialytic High-Intensity Interval Training in Hemodialysis Patients

Study Overview
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Brief Summary
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Chronic Kidney Disease (CKD) is defined as a chronic, progressive degeneration state in the regulation of the fluid-electrolyte balance of the kidney and metabolic-endocrine functions as a result of the glomerular filtration rate (GFR) falling below 60 ml/min/1.73 m², regardless of the etiology of the kidney disease. End Stage Renal Failure (ESRD) is the last stage of CRF and is a life-threatening condition. Although the majority of ESRD patients survive on dialysis, their quality of life and functional capacity decrease due to uremic cardiomyopathy, cardiovascular diseases, anemia, diabetes mellitus, bone diseases, deconditioning, fatigue, weakness, inactivity and accompanying psychological problems. Rehabilitation program including exercise in CKD patients; The program, which is performed under observation on non-dialysis days, can be applied in three ways: the (intradialytic) rehabilitation program performed during hemodialysis in the dialysis unit, and the home exercise program. Intradialytic exercise (IDE) is defined as exercise training performed during the hemodialysis session to increase the patient's strength and endurance and thus target various physiological and psychosocial parameters. Three types of exercises are generally recommended in the exercise program for dialysis patients. These are aerobic exercise, strengthening exercise, and combined aerobic and resistance exercise program. Aerobic exercise (both on dialysis and on non-dialysis days) is the most common type of exercise used in hemodialysis patients. It is stated that physical exercise improves the exercise capacity, muscle strength, functional capacity and quality of life of patients receiving dialysis treatment, provides blood pressure control, reduces the risk of diabetes development and cardiovascular disease, alleviates depression and anxiety symptoms, increases survival and dialysis efficiency. When the literature is examined, no study has been found that examines how the application of high-intensity intermittent exercise training, which has very important advantages, in the intradialytic process has an effect. Therefore, the aim of our study is to compare the effects of intradialytic high-intensity intermittent exercise training and moderate-intensity exercise training on dialysis effectiveness, functional capacity and quality of life in hemodialysis patients.

Official Title
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The Effect of Intradialytic High-Intensity Interval Training and Moderate Intensity Training on Dialysis Adequacy and Functional Capacity in Hemodialysis Patients

Conditions
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End Stage Renal Disease, Exercise, Compulsive

Intervention / Treatment
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* Other: High Intensity Interval Exercise Training
* Other: Moderate Intensity Exercise Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Between the ages of 20-65 Having Stage 5 (ESRD) CRF according to GFR Literate Cooperative Dialysis treatment for at least three months Exclusion Criteria: History of myocardial ischemia in the last 6 months Uncontrollable diabetes mellitus, Uncontrollable hypertension Heart failure Malignant disease Mental retardation Illiteracy Uncooperative Neurological or orthopedic disability

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Group 1<br>High intensity interval training | Other: High Intensity Interval Exercise Training<br>* High Intensity Interval Training Group<br>|
| Active Comparator: Group 2<br>Moderate intensity training | Other: Moderate Intensity Exercise Training<br>* Moderate Intensity Training Group<br>|
| No Intervention: Group 3<br>Control | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dialysis Adequacy | Kt/V | 8 weeks | 
| 6 Minute Walking Test | Functional Capacity | 8 weeks | 
| 5X Sit-to-Stand Test | Functional Capacity | 8 weeks | 
| Kidney Disease Quality of Life-36 | Life Quality | 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Depression Scale | Mild depression (11-17 points) Moderate depression (18-29 points) Severe depression (30-63 points) | 8 weeks | 
| Visual Analogue Scale | To evaluate Fatigue. Each line is 100 mm in length - thus, scores fall between 0 and 100.Scoring : 0 : not all tired 100: extremely tired (left end of scale=not tired at all, right end of scale=extremely tired) | 8 weeks | 
| Quadriceps muscle strength | Muscle testing with dynamometer | 8 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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intradialytic exercise, high-intensity interval training, chronic kidney disease, dialysis adequacy, functional capacity