Effect of Exercises on Hemodialysis

Ⅰ-Subjects: o Sixty-nine adult patients from both sexes. They were suffering from ESRD on maintenance hemodialysis, their age ranged from50-60 years old were selected from hemodialysis unit at Itay El Baroud central hospital. They were referred by the physician. Study group (A): the study group consisted of (23) patients who received aerobic exercise in form of (foot pedal exerciser) for 20 Minutes for each session, 3 sessions per week, for 8 weeks plus maintain on their medical treatment and hemodialysis. Study group (B): the study group consisted of (23) who received active free range of motion exercise (open kinetic chain active free range of motion) for 20 minutes for each session, 3 sessions per week, for 8 weeks plus maintain on their medical treatment and hemodialysis. Control group (C): the control group consisted of (23) patients who were maintained on their medical treatment and hemodialysis. II- Instrumentation 6-Minutes walk test: The 6-min walk test (6MWT) is frequently used to measure physical function in transplanted patients. * Fatigue Questionnaire (Fatigue Severity Scale) it was used to assess the level of fatigue. * Laboratory investigation: urea and creatinine are commonly used to monitor the effects of exercise on urea clearance and kidney function improvement in transplant patients. * The Mini-Cog test: is a quick, simple, and effective screening tool for early cognitive impairment in hemodialysis patients, making it ideal for busy clinical settings. B-Therapeutic Equipment: Foot pedal exerciser (fig.9): * Simple horizontal foot pedal exerciser used during hemodialysis sessions. * Dual pedals with non-slip straps for foot stability. * Manual resistance adjustment via a single control knob (non-electric). * Provides gradual increase in workload intensity. * Compact and light weight design suitable for use while lying on the dialysis bed. * Enables controlled, low-impact circular movement of the feet. * Aims to improve circulation and strengthen lower limb muscles without requiring active sitting. * Approximate device dimensions: 50 cm (length) x 40 cm (width) x 23 cm (height). * Maximum recommended user weight: 70 kg. Participants completed the 30-min aerobic exercise sessions during the first 2 hrs. of each dialysis session, 3 times per week for 8 weeks, using a simulated bike riding. Patients will perform active free exercise for upper limb (the arm that hasn't shunt) and lower limbs. Each exercise session consisted of three phases: warm up, conditioning, and cool down.