Effects of a Nurse-Led Multicomponent Exercise Intervention for Haemodialysis Patients With Possible or Confirmed Sarcopenia: A Cluster Randomised Trial
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Genlian Cai1,2, Liuqian Zhang1,2, Yujiao Zhang1,2
1Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Aims:
To assess the potential effects, safety and feasibility of a nurse-led multicomponent exercise intervention on skeletal muscle function and quality of life in haemodialysis patients with possible or confirmed sarcopenia.
Design:
A cluster randomised trial with clusters defined by fixed haemodialysis schedules.
Methods:
A total of 56 eligible participants were enrolled and allocated through cluster randomisation. The intervention group (n = 28) received a 12-week nurse-led multicomponent exercise intervention in addition to standard care, whereas the control group (n = 28) received standard care. The primary outcomes included skeletal muscle mass index (SMI), handgrip strength, gait speed and short physical performance battery (SPPB) scores. Secondary outcomes included scores on the Kidney Disease Quality of Life 36-Item Short-Form Survey (KDQOL-36) and C-reactive protein levels. Handgrip strength, gait speed, SPPB scores and KDQOL-36 scores were assessed at baseline and at Weeks 4, 8 and 12 during the intervention period, whereas SMI and C-reactive protein were assessed at baseline and Week 12. An intention-to-treat analysis was employed, and the effects of the intervention were evaluated using linear mixed models.
Results:
Of the 56 participants, 50 completed the study. The intervention group showed favourable trends in handgrip strength, gait speed and SPPB scores, with moderate-to-large effect sizes; however, these differences were not statistically significant after Bonferroni correction. Furthermore, no significant between-group differences were found in skeletal muscle mass index, health-related quality of life, or C-reactive protein levels. No serious intervention-related adverse events were reported.
Conclusions:
The nurse-led multicomponent exercise intervention was safe and feasible and showed favourable trends in muscle strength and physical function, although statistically significant between-group differences were not retained after correction for multiple comparisons.
Implications For Patient Care:
A nurse-led, multicomponent exercise intervention may have the potential to increase muscle strength and physical function in haemodialysis patients with possible or confirmed sarcopenia.
Impact:
What problem did the study address? This study assessed the potential effects, safety, and feasibility of a nurse-led, multicomponent exercise intervention designed for haemodialysis patients with possible or confirmed sarcopenia. What were the main findings? A nurse-led exercise intervention appeared safe and feasible and may help to improve muscle strength and physical function in haemodialysis patients with possible or confirmed sarcopenia. However, future studies with larger sample sizes and longer follow-up periods are needed to assess the long-term effects. Where and on whom will the research have an impact? The results of this study may inform the development and future implementation of nurse-led exercise interventions for haemodialysis patients with sarcopenia.
Patient And Public Contributions:
Patients and family members were invited to collaborate with healthcare professionals in designing a nurse-led, multicomponent exercise intervention programme. Their contributions helped improve the feasibility and practicality of the exercise intervention.
Reporting Method:
The CONSORT 2025 checklist was used in the reporting of the study.
Trial Registration:
This trial was registered at www.chictr.org.cn (registration number: ChiCTR2200065863).