Effect of Intradialytic Lower Limb Resisted Exercise on Muscle Strength, Exercise Capacity and Quality of Life in Patients with Chronic Kidney Disease on Maintenance Hemodialysis: A Case Series

Background: Chronic Kidney Disease (CKD) patients undergoing maintenance hemodialysis (MHD) are often physically deconditioned due to multiple factors such as uremic toxins, malnutrition, and physical inactivity. Which leads to muscle weakness, reduced exercise tolerance, and physical frailty. Hence, quality of life is significantly impaired. Intradialytic exercise, which involves physical activity during dialysis, can be a viable intervention to address these challenges. Purpose: To evaluate the effect of intradialytic Lower Limb (LL) resisted exercise on muscle strength, exercise capacity, and quality of life in patients with CKD on MHD. Method: 4 patients (3 male and 1 female, age 20-29 years) of CKD on MHD were on dialysis for more than 12 months and had no contraindications to exercise. Pre- and post-assessment were taken with 1- Repetition maximum (1-RM), 6-min Walk Test (6-MWT), Hand Grip Strength (HGS), Bioelectrical Impedance Analysis (BIA), and Kidney Disease and Quality of Life Instrument-36 (KDQOL-36). Patients performed a structured intradialytic exercise program during their hemodialysis, focused on lower limb strength using a weight cuff [Load- 65%-75% of 1-RM, Frequency- 2 times/week, 3-4 sets of 10-15 repetitions, Duration- 6 weeks]. Result: 6 weeks of intradialytic LL-resisted exercise resulted in notable improvement in muscle strength in terms of 1-RM, exercise capacity in terms of 6-MWT, and quality of life (KDQOL-36) in patients with CKD on MHD Conclusion: This case series shows that intradialytic LL-resisted exercise is a promising intervention for improving muscle strength, exercise capacity, and Quality of Life (QoL) in patients with CKD on MHD. Keywords: Intradialytic exercise, Muscle strength, Exercise capacity, Quality of life, CKD, Case series.