Effect of Intradialytic Exercise Program on Physical Function, Depression and Quality of Life in Diabetic Nephropathy Patients: A Pre-post Interventional Study

Introduction: Diabetic Nephropathy (DN) is a prevalent complication of Diabetes Mellitus (DM) that frequently results in impaired physical functioning, a reduced Quality of Life (QoL) and a decline in psychological well-being. Patients who undergo Haemodialysis (HD) are at a higher risk of experiencing depression, fatigue and functional decline. Although there is potential for exercise therapy to improve outcomes for Chronic Kidney Disease (CKD), limited evidence exists regarding its structured application in DN patients receiving HD. Aim: To assess the effect of Intradialytic Exercise (IDE) program on the physical function, depression and QoL of DN patients who are undergoing HD. Materials and Methods: This pre-post interventional study was carried out at Department of Nephrology in Justice KS Hegde Charitable Hospital, Deralakatte, Mangaluru, India. The study was conducted from July 2024 to February 2025 and involved 15 patients with DN who were receiving maintenance HD.Participants underwent an 8-week IDE program (three sessions per week for one hour each). To assess the intervention’s effects, outcome measures included the 6-Minute Walk Test (6MWT), 30 -Second Sit-to-Stand test (30STS), handgrip strength, lower limb strength, the Hospital Anxiety and Depression Scale (HADS) and the Kidney Disease Quality of Life-36 (KDQoL-36). Paired sample t-tests were used to evaluate difference between baseline and post intervention scores. Results: Significant improvements were observed in 6MWT (9.98%), 30 STS (38.06%), handgrip strength (10.62%) and lower limb strength (20.75%) (p<0.001). Depression scores on the HADS significantly decreased (24.14%) (p=0.001), while the KDQoL-36 scores indicated a marked enhancement (10.46%) in QoL (p=0.008). Conclusion: Intradialytic exercise program significantly improves physical function, reduces signs of depression and enhances the QoL of DN patients receiving HD.