Effectiveness of Intradialytic Exercise on Fatigue in Chronic Kidney Failure Patients Undergoing Hemodialysis Therapy
Abstract
Fatigue is one of the most common symptoms experienced by patients undergoing hemodialysis therapy. This condition can affect the quality of life of chronic patients, because reduced physical activity, such as sedentary habits, and emotional stress can also be the cause of fatigue. Intradialitic exercise has various benefits in reducing fatigue experienced by patients. This study aims to evaluate the effect of exercise training on the level of fatigue in patients undergoing hemodialysis therapy. The study used a design Quasi-experimental research using the pre-test and post test group design. The research population was all patients with end-stage renal failure with the sampling technique being accidental sampling, with amount sample of 22 patients. Intradialytic exercises were performed for six weeks at a frequency of twice a week, with each session lasting a maximum of 20 minutes. Fatigue levels were measured using the Functional Assessment of Chronic Illness Therapy (FACIT) questionnaire. Data analysis was performed using the dependent t-test. The results of the study showed that the average level of fatigue before the intervention is 26.36 (SD ± 3.580 ), while the average score is the fatigue level after intervention is 32.09 (SD ±4.116 ) with a p value of 0.001, the effect size is -3.378, then including in category effect tall based on Cohen'. There is significant difference between fatigue levels before and after interdialytic exercise in patients with chronic renal failure undergoing hemodialytic therapy.
References
Abo, E., Elkazeh, E. E., El Shemy, M. B. A., Abo Elghiteelhossinyelkazeh, E., & El Kually, R. (2016). Efficacy Of Exercise Program In Intra HemodialysisOnpatients’Quality Of Life. Assiut Scientific Nursing Journal, 5(1), 17–30. https://doi.org/10.9790/1959-05151730
Alemañy, G. M. (2017). Benefits of Physical Exercise in Patients with Chronic Kidney Disease and Hemodialysis: A Mini Review. Urology & Nephrology Open Access Journal, 5(4). https://doi.org/10.15406/unoaj.2017.05.00177
Alvarez, L., Brown, D., Hu, D., Chertow, G. M., Vassalotti, J. A., & Prichard, S. (2020). Intradialytic Symptoms and Recovery Time in Patients on Thrice-Weekly In-Center Hemodialysis: A Cross-sectional Online Survey. Kidney Medicine, 2(2), 125–130. https://doi.org/10.1016/j.xkme.2019.10.010
Amini, E., Goudarzi, I., Masoudi, R., Ahmadi, A., & Momeni, A. (2016). Effect of Progressive Muscle Relaxation and Aerobic Exercise on Anxiety, Sleep Quality, and Fatigue in Patients with Chronic Renal Failure Undergoing Hemodialysis. In International Journal of Pharmaceutical and Clinical Research (Vol. 8, Issue 12). www.ijpcr.com
Bossola, M., & Tazza, L. (2016). Postdialysis Fatigue: A Frequent and Debilitating Symptom. In Seminars in Dialysis (Vol. 29, Issue 3, pp. 222–227). Blackwell Publishing Inc. https://doi.org/10.1111/sdi.12468
Cervantes, L., Hull, M., Keniston, A., Chonchol, M., Hasnain-Wynia, R., & Fischer, S. (2018). Symptom Burden among Latino Patients with End-Stage Renal Disease and Access to Standard or Emergency-Only Hemodialysis. Journal of Palliative Medicine, 21(9), 1329–1333. https://doi.org/10.1089/jpm.2017.0663
Chang, Y., Cheng, S. Y., Lin, M., Gau, F. Y., & Chao, Y. F. C. (2010). The effectiveness of intradialytic leg ergometry exercise for improving sedentary life style and fatigue among patients with chronic kidney disease: A randomized clinical trial. International Journal of Nursing Studies, 47(11), 1383–1388. https://doi.org/10.1016/j.ijnurstu.2010.05.002
Dashtidehkordi, A., Shahgholian, N., & Attari, F. (2019). Exercise during hemodialysis and health promoting behaviors: a clinical trial. BMC Nephrology, 20(1). https://doi.org/10.1186/s12882-019-1276-3
EL Shemy, M., Elkazeh, E. A. E., & Radwal Elkually. (2016). Efficacy Of Exercise Program In Intra Hemodialysis On patients’Quality Of Life. 5(1), 17–30. https://doi.org/10.9790/1959-05151730
Eslami, A. A., Rabiei, L., Abedi, H. A., Shirani, M., & Masoudi, R. (2016). Coping Skills of Iranian Family Caregivers’ in Caretaking of Patients Undergoing Haemodialysis: a Qualitative Study. Journal of Renal Care, 42(3), 162–171. https://doi.org/10.1111/jorc.12166
Hall, Y. N., Larive, B., Painter, P., Kaysen, G. A., Lindsay, R. M., Nissenson, A. R., Unruh, M. L., Rocco, M. V., & Chertow, G. M. (2012). Effects of six versus three times per week hemodialysis on physical performance, health, and functioning: Frequent hemodialysis network (FHN) randomized trials. Clinical Journal of the American Society of Nephrology, 7(5), 782–794. https://doi.org/10.2215/CJN.10601011
Hassan Abd Elhameed, S., & El Sayed Fadila, D. (2019). Effect of Exercise Program on Fatigue and Depression among Geriatric Patients Undergoing Hemodialysis. International Journal of Advanced Nursing Studies, 8(2), 23–32. https://doi.org/10.14419/ijans.v8i2.29316
Huang, M., Lv, A., Wang, J., Xu, N., Ma, G., Zhai, Z., Zhang, B., Gao, J., & Ni, C. (2019). Exercise Training and Outcomes in Hemodialysis Patients: Systematic Review and Meta-Analysis. In American Journal of Nephrology (Vol. 50, Issue 4, pp. 240–254). S. Karger AG. https://doi.org/10.1159/000502447
Jung, T.-D., & Park, S.-H. (2011). Intradialytic Exercise Programs for Hemodialysis Patients. Chonnam Medical Journal, 47(2), 61. https://doi.org/10.4068/cmj.2011.47.2.61
Kaplan Serin, E., Ovayolu, N., & Ovayolu, Ö. (2020). The Effect of Progressive Relaxation Exercises on Pain, Fatigue, and Quality of Life in Dialysis Patients. Holistic Nursing Practice, 34(2), 121–128. https://doi.org/10.1097/HNP.0000000000000347
Kulkarni, G. S., & Dani, P. (2018). Effectiveness of leg stretch exercises on level of fatigue among patients undergoing hemodialysis. International Journal of Nursing Education, 10(4), 35. https://doi.org/10.5958/0974-9357.2018.00097.1
Locatelli, F., & Canaud, B. (2012). Dialysis adequacy today: A European perspective. In Nephrology Dialysis Transplantation (Vol. 27, Issue 8, pp. 3043–3048). https://doi.org/10.1093/ndt/gfs184
Lu, Y., Wang, Y., & Lu, Q. (2019). Effects of Exercise on Muscle Fitness in Dialysis Patients: A Systematic Review and Meta-Analysis. American Journal of Nephrology, 50(4), 291–302. https://doi.org/10.1159/000502635
Luyckx, V. A., Tonelli, M., & Stanifer, J. W. (2018). The global burden of kidney disease and the sustainable development goals. Bulletin of the World Health Organization, 96(6), 414-422C. https://doi.org/10.2471/BLT.17.206441
Merline, Sc, M., Deepa, R., & Nirmala, T. (2018). Effect of intradialytic exercise on fatigue among patients undergoing hemodialysis at selected hospital, Coimbatore. 4(4), 393–394. www.allresearchjournal.com
Maheshwari, V., Samavedham, L., & Rangaiah, G. P. (2011). A regional blood flow model for β2-microglobulin kinetics and for simulating intra-dialytic exercise effect. Annals of Biomedical Engineering, 39(12), 2879–2890. https://doi.org/10.1007/s10439-011-0383-5
Mohamed Soliman, H. M. (2015a). Effect of intradialytic exercise on fatigue, electrolytes level and blood pressure in hemodialysis patients: A randomized controlled trial. Journal of Nursing Education and Practice, 5(11). https://doi.org/10.5430/jnep.v5n11p16
Mohamed Soliman, H. M. (2015b). Effect of intradialytic exercise on fatigue, electrolytes level and blood pressure in hemodialysis patients: A randomized controlled trial. Journal of Nursing Education and Practice, 5(11). https://doi.org/10.5430/jnep.v5n11p16
Motedayen, Z., Nehrir, B., Tayebi, A., Ebadi, A., & Einollahi, B. (2014). The effect of the physical and mental exercises during hemodialysis on fatigue: A controlled clinical trial. Nephro-Urology Monthly, 6(4). https://doi.org/10.5812/numonthly.14686
Putu, I., Darmawan, E., Oka, P., Nurhesti, Y., & Ketut Suardana, I. (2019). Hubungan Lamanya Menjalani Hemodialisis Dengan Fatigue Pada Pasien Chronic Kidney Disease (Vol. 7, Issue 3).
Rhee, S. Y., Song, J. K., Hong, S. C., Choi, J. W., Jeon, H. J., Shin, D. H., Ji, E. H., Choi, E. H., Lee, J., Kim, A., Choi, S. W., & Oh, J. (2019). Intradialytic exercise improves physical function and reduces intradialytic hypotension and depression in hemodialysis patients. Korean Journal of Internal Medicine, 34(3), 588–598. https://doi.org/10.3904/kjim.2017.020
Riset Kesehatan Dasar. (2018). Laporan_Nasional_RKD2018_FINAL.pdf. In Badan Penelitian dan Pengembangan Kesehatan (pp. 221–222).
Rivara, M. B., & Mehrotra, R. (2018). Timing, Initiation, and Modality Options for Renal Replacement Therapy. In Chronic Kidney Disease, Dialysis, and Transplantation: A Companion to Brenner and Rector’s The Kidney (pp. 286-296.e4). Elsevier. https://doi.org/10.1016/B978-0-323-52978-5.00019-7
Rizki Muliani, A. R. M. I. A. (2021). Intradialytic Exercise: Flexibility terhadap Skor Fatigue pada Pasien Penyakit Ginjal Kronis yang Menjalani Hemodialisis.
Safruddin, S., & Asnaniar, W. S. (2019). Pengaruh Breathing Exercise Terhadap Level Fatigue Pasien Gagal Ginjal Yang Menjalani Hemodialisis. JIKP Jurnal Ilmiah Kesehatan PENCERAH, 8(01), 52–58.
Salhab, N., Karavetian, M., Kooman, J., Fiaccadori, E., & El Khoury, C. F. (2019). Effects of intradialytic aerobic exercise on hemodialysis patients: a systematic review and meta-analysis. In Journal of Nephrology (Vol. 32, Issue 4, pp. 549–566). Springer International Publishing. https://doi.org/10.1007/s40620-018-00565-z
Saraswati, N. L. G. I. L. N. K. Y. (2024). Tingkat Fatigue Pada Pasien Yang Menjalani Hemodialisis Fatigue Level In Patients Undergoing Hemodialisis. Journal Nursing Research Publication Media, 3. https://doi.org/10.55887/nrpm.v3i2.128
Sheng, K., Zhang, P., Chen, L., Cheng, J., Wu, C., & Chen, J. (2014). Intradialytic exercise in hemodialysis patients: A systematic review and meta-analysis. American Journal of Nephrology, 40(5), 478–490. https://doi.org/10.1159/000368722
Song, Y. yuan, Hu, R. jun, Diao, Y. shu, Chen, L., & Jiang, X. lian. (2018). Effects of Exercise Training on Restless Legs Syndrome, Depression, Sleep Quality, and Fatigue Among Hemodialysis Patients: A Systematic Review and Meta-analysis. In Journal of Pain and Symptom Management (Vol. 55, Issue 4, pp. 1184–1195). Elsevier Inc. https://doi.org/10.1016/j.jpainsymman.2017.12.472
Wanek, M. R., Horn, E. T., Elapavaluru, S., Baroody, S. C., & Sokos, G. (2012). Safe use of hemodialysis for dabigatran removal before cardiac surgery. Annals of Pharmacotherapy, 46(9). https://doi.org/10.1345/aph.1R081
Copyright (c) 2025 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
