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Effectiveness of Physiotherapy in Haemodialysis: Systematic Review
Juan Rodríguez-Mansilla1, Carmen Murillo-González2, María Jiménez-Palomares1
1ADOLOR Research Group, Department of Medical-Surgical Therapy, Medicine Faculty and Health Sciences, University of Extremadura, 06006 Badajoz, Spain.
Insights
Physiotherapy, including exercise, significantly benefits patients undergoing haemodialysis by improving strength, aerobic capacity, and quality of life. It also reduces fatigue and depression, supporting comprehensive chronic kidney disease management.
Area of Science:
- Nephrology
- Physical Therapy
- Public Health
Background:
- Chronic kidney disease (CKD) is a global health challenge with high prevalence and mortality.
- Advanced CKD necessitates haemodialysis (HD), often leading to physical complications.
- Physiotherapy integration is crucial for managing HD patients' physical well-being.
Purpose of the Study:
- To systematically review the effectiveness of physiotherapy interventions for patients undergoing haemodialysis.
- To analyze the impact of physiotherapy administered before, during, and after HD sessions.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searched PubMed, PEDro, Cochrane Library, ScienceDirect, and Dialnet for relevant studies.
- Included controlled and uncontrolled clinical trials from the last 10 years, in English or Spanish, involving adult CKD patients on HD.
Main Results:
- 22 studies involving 1786 patients were included.
- Common exercise modalities included cycloergometers, treadmills, and bicycles.
- Interventions comprised aerobic, endurance, and inspiratory muscle training, with varied assessment timings.
Conclusions:
- Therapeutic exercise demonstrably improves muscle strength, aerobic capacity, and quality of life in HD patients.
- Physiotherapy implementation before, during, and after HD sessions reduces fatigue and depression.
- Exercise is vital for the holistic management of CKD patients on haemodialysis.
Background:
Chronic kidney disease (CKD) is a progressive pathology that affects millions of people worldwide, becoming a public health challenge due to its high prevalence and mortality. In its advanced stages, patients require therapies such as haemodialysis (HD), which often entails physical complications, so incorporating physiotherapy as an essential part of the treatment of these patients becomes evident.
Objective:
To analyse the effectiveness of physiotherapy in patients undergoing haemodialysis before, during and after the treatment.
Methodology:
This study is a systematic review conducted following the PRISMA statements. An electronic literature search was performed in the following databases: PubMed, PEDro, Chorane Library, ScienceDirect and Dialnet. The inclusion criteria were: controlled and uncontrolled clinical trials published in the last 10 years in English or Spanish, in patients with chronic kidney disease on haemodialysis treatment, aged 18 years or older.
Results:
22 studies were included in this review. A total of 1786 patients participated in the included studies. Most of the investigations used cycloergometers, treadmills and bicycles. The programmes varied in types of exercise, with combinations of aerobic, endurance and inspiratory muscle training, with assessments at baseline and at the end of the intervention, some with additional measurements at 8, 12 or 16 weeks, and others with no specified follow-up time.
Conclusions:
The analysed literature showed that therapeutic exercise can be beneficial for haemodialysis patients, improving muscle strength, aerobic capacity and quality of life. Its implementation, both before, during and after haemodialysis sessions, also helped to reduce fatigue and depression. These results support the importance of exercise in the comprehensive treatment of patients with chronic kidney disease in haemodialysis.
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