Effectiveness of Otago exercise on sleep quality and dialysis adequacy in hemodialysis patients

Patients undergoing hemodialysis commonly experience complications such as poor sleep quality and inadequate dialysis efficiency. Therefore, effective nursing interventions are essential to mitigate these issues. This study was conducted with the aim of determining the effect of home-based Otago exercise on sleep quality and dialysis adequacy among patients undergoing hemodialysis in selected hospitals affiliated with Iran University of Medical Sciences in Tehran. In this randomized controlled clinical trial, 46 hemodialysis patients were recruited from two dialysis centers in Tehran and randomly allocated into intervention and control groups using block randomization. The intervention group performed home-based Otago exercises three sessions per week for eight weeks, following initial training and regular follow-up. The outcome measures included the Pittsburgh Sleep Quality Index (PSQI) questionnaire and dialysis adequacy indices (Kt/V and URR), which were assessed both before and after the intervention in both groups. Data were analyzed using descriptive and inferential statistical tests through SPSS software version 16. Out of 45 participants, 44 completed the study. The two groups were demographically homogeneous. After the intervention, the intervention group showed significant improvements in sleep quality (P < 0.001), KT/V (P = 0.002), and URR (P = 0.006). Between-group comparisons also showed significant differences in sleep quality (P = 0.006) and KT/V (P = 0.023), but not in URR (P = 0.693). Home-based Otago exercise can be used as a safe, low-cost, and effective intervention to improve both sleep quality and dialysis adequacy in patients undergoing hemodialysis. It is recommended that implementation of this home exercise program be taught to patients and followed up regularly. This trial was registered at the Iranian Registry of Clinical Trials: IRCT20210911052440N1)Date of registration: 2022-02-25) https://irct.behdasht.gov.ir/trial/58681.