The Impact of Intradialytic Exercise on Activities of Daily Living and Physical Function in Hospitalized Hemodialysis Patients: A Study of Efficacy and Safety

Introduction: This study aimed to examine the effects of intradialytic exercise (IDE) on improving activities of daily living (ADL) and physical function in hospitalized hemodialysis (HD) patients. The research question focused on improving outcomes in ADL and physical function. Methods: This study is a single-center, historical cohort study. Subjects were hospitalized HD patients undergoing rehabilitation between April 2017 and February 2023. Patients were divided into two groups: the IDE group, which received IDE, and the non-IDE group, which did not. The outcomes measured were Barthel Index (BI), grip strength, isometric knee extension strength (IKES), 10-meter walking speed (10MWS), and Short Physical Performance Battery (SPPB). Outcome measures were taken at admission and discharge, and changes were analyzed using a linear mixed model. Results: The study included 76 participants (IDE group: 13, non-IDE group: 63). The IDE group showed significant improvements in Delta BI (13.7 [0.96-26.38] points) and Delta 10MWS (0.25 [0.05-0.45] m/sec) (p < 0.05). No significant differences were observed between the two groups in Delta Grip strength (2.10 [-0.40 to 4.60] kg), Delta IKES (7.40 [-2.20 to 17.02] %), or Delta SPPB (1.23 [-0.48 to 2.94] points) (p > 0.05). However, the IDE group showed significant pre-post improvements in grip strength (1.55 [1.46-1.65] kg) and SPPB (2.44 [1.34-3.55] points) (p < 0.05). Conclusions: IDE contributed to greater improvements in BI and 10MWS in HD patients. These findings suggest that adding IDE to inpatient rehabilitation may enhance functional recovery in this population.