title: Effects of an intradialytic resistance training programme on physical function: a prospective stepped-wedge randomized controlled trial.
abstract: Intradialytic exercise programmes are important because of the deterioration in physical function that occurs in people receiving haemodialysis. Unfortunately, exercise programmes are rarely sustained in haemodialysis clinics. The aim of this study was to determine the efficacy of a sustainable resistance exercise programme on the physical function of people receiving haemodialysis.
  
  
  
  A total of 171 participants from 15 community satellite haemodialysis clinics performed progressive resistance training using resistance elastic bands in a seated position during the first hour of haemodialysis treatment. We used a stepped-wedge design of three groups, each containing five randomly allocated cluster units allocated to an intervention of 12, 24 or 36 weeks. The primary outcome measure was objective physical function measured by the 30-s sit-to-stand (STS) test, the 8-foot timed up and go (TUG) test and the four-square step test. Secondary outcome measures included quality of life, involvement in community activity, blood pressure and self-reported falls.
  
  
  
  Exercise training led to significant improvements in physical function as measured by STS and TUG. There was a significant average downward change (β = -1.59, P < 0.01) before the intervention and a significant upward change after the intervention (β = 0.38, P < 0.01) for the 30-s STS with a similar pattern noted for the TUG.
  
  
  
  Intradialytic resistance training can improve the physical function of people receiving dialysis.
authors.affiliation: School of Nursing and Midwifery, Deakin University, Geelong, VIC, Australia Centre for Nursing Research, Western Health, Melbourne, VIC, Australia.
authors.forename: Paul Norman
authors.initials: PN
authors.lastname: Bennett
authors.affiliation: School of Exercise & Nutrition Sciences, Deakin University, Burwood, VIC, Australia.
authors.forename: Steve
authors.initials: S
authors.lastname: Fraser
authors.affiliation: South Australia Department of Health, Centre for Physical Activity in Ageing-Central Adelaide Local Health Network, Adelaide, SA, Australia.
authors.forename: Robert
authors.initials: R
authors.lastname: Barnard
authors.affiliation: Physiotherapy Department, School of Primary Health Care, Monash University and Monash Health, Monash, VIC, Australia.
authors.forename: Terry
authors.initials: T
authors.lastname: Haines
authors.affiliation: Centre for Nursing Research, Deakin University & Monash Health Partnership, Monash, VIC, Australia.
authors.forename: Cherene
authors.initials: C
authors.lastname: Ockerby
authors.affiliation: Nursing and Midwifery Research Centre, Deakin University-Eastern Health, Box Hill, VIC, Australia.
authors.forename: Maryann
authors.initials: M
authors.lastname: Street
authors.affiliation: School of Nursing and Midwifery, Deakin University, Burwood, VIC, Australia.
authors.forename: Wei Chun
authors.initials: WC
authors.lastname: Wang
authors.affiliation: School of Exercise & Nutrition Sciences, Deakin University, Burwood, VIC, Australia.
authors.forename: Robin
authors.initials: R
authors.lastname: Daly
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome
keywords: exercise therapy; randomized controlled trial; renal dialysis; resistance training