Implementation of exercise therapy in kidney failure

Abstract

Background Low levels of physical activity in patients with chronic kidney disease have long been shown to impact adversely on functional status and quality of life. Numerous studies have demonstrated the benefits of exercise in patients on haemodialysis. However, implementation of exercise programs as routine practice remains lacking, likely due to the variability of methodology across published studies as well as limitations at dialysis facilities. Objectives We share our experience in providing exercise therapy that is prioritised as routine patient care in a community dialysis setting; interventions are individualised to each patient’s functional ability based on thorough and regular assessment. Approach Exercise therapy is structured whereby patients’ functional status and abilities are evaluated in detail prior to placement into exercise programs and at regular progress intervals. Each exercise program, facilitated by exercise specialists, is tailored to the patients’ functional capability and health status using exercises that are modifiable to their needs. Group exercises also provide an avenue of social interaction and support for patients. Conclusion Exercise therapy is advocated strongly to improve function and quality of life in patients on dialysis. Through implementation of a range of multifaceted and individualised exercise programs, we address both their functional and psychosocial needs. Our unique holistic approach aims to facilitate patient adherence in a sustainable manner.