Uptake of and adherence to exercise during hospital haemodialysis

Objectives To determine the uptake of and adherence to exercise during hospital haemodialysis. Design Eight-week intradialytic cycling programme, supervised by 11 physiotherapist. Participants Forty-nine patients who were being treated by hospital haemodialysis in Dumfries at the start of July 2003. Main outcome measure The percentage of patients who were still exercising at the end of the 8-week programme. Results Three patients were ineligible: one died, one moved to another centre and one transferred to peritoneal dialysis. Eight (17%) patients were not interested in taking part in the study and 16 (35%) had medical problems that prevented them from taking part. Twenty-two of the remaining 46 (48%) patients began the programme. Those who exercised were younger (58 versus 67 years) and had fewer comorbidities (1.3 versus 2.1) than patients who did not exercise. Seventeen patients (77% of those who started exercising and 38% of those eligible to exercise) were still cycling at the end of the 8-week period. Sixteen of the 22 patients felt that they had benefited from the programme, and all 22 patients said that the programme should continue. Conclusions Around 40% of haemodialysis patients may be suitable for and able to complete an 8-week intradialytic cycling programme. This is a higher rate of adherence to exercise than reported in the literature. Our experience of haemodialysis patients in south-west Scotland suggests that uptake and adherence may be maximised by the presence of a physiotherapist during each dialysis session, and by targeting patients for exercise during dialysis rather than in an outpatient setting. (c) 2005 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.