People with chronic kidney disease (CKD) undergoing hemodialysis (HD) experience muscular complications, such as sarcopenia, which worsen their functional capacity and increase mortality. Exercise programs during HD are an effective strategy to combat sedentary behavior, and implementing them through innovative technologies could facilitate their adoption in clinics, benefiting more patients. Therefore, the study's objectives are to assess the feasibility and safety of a group exercise program supported by audiovisual media conducted during HD sessions. Additionally, it will analyze factors influencing adherence, identify potential causes for interruptions or failure to perform the prescribed exercise, and evaluate the risk and prevalence of sarcopenia, its association with low muscle strength, poor muscle quality, and physical inactivity.
A 4-week randomized experimental study will be conducted, using an exercise protocol during HD, broadcast simultaneously on television. The frequency of exercise completion, reasons for non-completion, adverse events, as well as sarcopenia, muscle strength, muscle characteristics through ultrasound and electrical bioimpedance, and physical activity levels will be evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
45
The intervention group will perform the group exercise protocol during HD sessions. The videos with the exercises will be broadcast on all televisions simultaneously, so that the volunteers perform the exercises along with the person in the video. * The first level of difficulty includes 5 exercises for the lower limbs and 3 exercises for the upper limbs. One set of 10 repetitions will be performed for each exercise per session. * The second level includes 3 exercises for the lower limbs and 2 exercises for the upper limbs. These consist of proprioceptive neuromuscular facilitation diagonals for both the lower and upper limbs. One set of 10 repetitions will be performed for each exercise, once per week, for 3 weeks. * The third level includes 8 combined lower and upper limb exercises performed simultaneously. One set of 20 repetitions will be performed for each exercise. Exercises will be performed 3 times per week over a 4-week period, for a total of 12 planned exercise sessions.
B. Braun Avitum - Centro de Atención Renal
Massamagrell, Valencia, Spain
Feasibility and Safety Assessment
Feasibility will be assessed through adherence rate (number of sessiones performed out of sessions offered).
Time frame: From start to finish of intervention (4 weeks)
Feasibility and Safety Assessment
Adverse events of the exercise during the study (number of adverse events)
Time frame: From start to finish of intervention (4 weeks)
Sarcopenia Risk Assessment
The risk of sarcopenia will be evaluated using the SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs and Falls )questionnaire. Score ranges from 0 a 10, higher scores mean higher risc of sarcopenia.
Time frame: It will be applied before and after the 4 weeks of intervention.
Muscle Strength Assessment
Handgrip strength
Time frame: It will be applied before and after the 4 weeks of intervention
Muscle Strength Assessment
Lower limb muscle strength assessments via digital manual dynamometry will be performed during HD using the MMT Lafayette Instrument Company hand dynamometer.
Time frame: It will be applied before and after the 4 weeks of intervention.
Muscle Characteristics
The quantity and quality of muscle mass will be evaluated by the cross-sectional area of the rectus femoris muscle, measured by muscle ultrasound.
Time frame: It will be applied before and after the 4 weeks of intervention
Muscle Characteristics
Body composition and appendicular skeletal muscle mass will also be measured by multi-frequency bioelectrical impedance analysis (BIA),
Time frame: It will be applied before and after the 4 weeks of intervention.
Physical Activity Level Assessment
The level of physical activity will be evaluated using the HAP questionnaire (Average Activity Score AAS).
Time frame: It will be applied before and after the 4 weeks of intervention.
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