Acute and long-term effects of an exercise program for dialysis patients prescribed in hospital and performed at home

Background: Exercise has positive psychophysical effects on dialysis patients, thus effective programs should be identified. We evaluated the effects of an original 6-month walking program on physical capacity, health-related quality of life (HRQL) and postdialysis fatigue (PDF). Methods: Thirty-one dialysis patients (19 male, mean age 65 +/- 11 years) were divided into exercise (group E; n=17) and control (group C; n=14) groups, and evaluated upon entry, after the 6-month program and 19 +/- 3 months later. Outcome measures were 6-minute walking distance (6MWD), SF-36 scale scores, self-reported PDF and recovery time. E group was assigned 2 daily 10-minute home walking sessions on the nondialysis day at a speed 50% below maximal treadmill speed as determined and updated monthly at the hospital. C group: no exercise. Results: Twenty patients (13 from E, 7 from C) completed the study. The E group, unlike the C group, increased 6MWD (308 +/- 105 m, to 351 +/- 118 m, p=0.0007), and HRQL, significantly for bodily pain, physical role and mental health (p<0.05), decreased PDF and recovery time (p<0.05). At the follow-up, 15 patients were reevaluated (9 from E, 6 from C). The E group was still active and showed 6MWD similar to baseline, with a decline of 0.13 +/- 1.72 m/mo. The C group decreased 6MWD (p=0.026) with a decline of 3.43 +/- 3.2 m/mo. For both groups, HRQL, PDF and recovery time showed slight variations from baseline. Conclusions: In dialysis patients, a 6-month exercise program prescribed at the hospital and performed at home improved physical capacity, HRQL and PDF symptoms. Patients maintained an active lifestyle after discharge and showed a slow functional decline over a 2-year period.