title: Comparing the effects of active and passive intradialytic pedaling exercises on dialysis efficacy, electrolytes, hemoglobin, hematocrit, blood pressure and health-related quality of life.
abstract: BACKGROUND
  The effect of exercise during hemodialysis has been a controversial issue, however, there are just few studies about the effect of active exercise during hemodialysis.
  
  
  OBJECTIVE
  This study aimed to compare the effects of passive and active intradialytic pedaling exercises on dialysis efficacy, electrolytes, hemoglobin, hematocrit, blood pressure and health-related quality of life in hemodialysis patients.
  
  
  METHODS
  This quasi-experimental study was conducted on 16 hemodialysis patients in Akhavan hemodialysis center in Kashan from April to November 2013. Active or passive intradialytic pedaling exercise was performed using a Mini-Bike for 30 minutes during the first two hours of the dialysis sessions. The quality of life (QOL) was assessed before and after the intervention. Blood pressure was examined at the beginning and then hourly during the dialysis sessions. Dialysis efficacy, levels of phosphorus, calcium, sodium, potassium and Blood urea nitrogen (BUN) were measured at the end of the intervention. Kolmogorov-Smirnov test, paired t test, Wilcoxon signed rank and Friedman tests and repeated measure analysis of variancewere used to analyze the data.
  
  
  RESULTS
  No significant changes were observed in serum potassium, phosphorus and calcium levels at the end of the passive exercise program compared to the baseline. However, phosphorus levels were significantly decreased in the active exercise program (P < 0.05). Moreover, the mean diastolic blood pressure was significantly decreased after the passive exercise (P = 0.039). Passive exercise did not significantly change the dialysis efficacy, urea reduction rate, hemoglobin and calcium levels. The mean overall QOL was 63.78 ± 21.15 at the beginning of the study, which was increased to 77.07 ± 21.14 at the end of eight weeks of the intradialytic exercise (P = 0.007).
  
  
  CONCLUSIONS
  The passive intradialytic exercise had a positive effect on blood pressure. The active exercise could decrease the serum phosphorus and potassium levels. Moreover, both exercise programs could significantly improve the QOL. Both active and passive intradialytic exercises can have some beneficial effects.
authors.affiliation: Department of Health (Community Health Nurse), Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Azra Sadat
authors.initials: AS
authors.lastname: Musavian
authors.affiliation: Department of Internal Medicine, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Soleimani
authors.affiliation: Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Negin
authors.initials: N
authors.lastname: Masoudi Alavi
authors.affiliation: Department of Dialysis, Akhavan Hospital, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Alimohammad
authors.initials: A
authors.lastname: Baseri
authors.affiliation: Department of Dialysis, Akhavan Hospital, Kashan University of Medical Sciences, Kashan, IR Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Savari
keywords: Exercise; Hemodialysis; Quality of Life
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