Comparison of the effectiveness of intradialitic core stabilization and aerobic exercise in hemodialysis patients

This study aimed to examine and compare the effects of intradialytic core stabilization and aerobic exercise. Thirty nine individuals receiving hemodialysis (HD) were included in the study. Individuals were randomly divided into an aerobic exercise group (AE, n = 20) and core stabilization exercise group (CSE, n = 19). While the first group performed aerobic exercises using a cycle ergometer, the second group performed core stabilization exercises consisting of four phases. Exercises were performed in the first two hours of dialysis, three days a week, for eight weeks. Before and after treatment, functional capacity (Five Times Sit to Stand Test, 10 Meter Walk Test, 2 Minute Step Test, Tinetti Gait and Balance Test), quality of life (Kidney Disease Quality of Life 36-KDQOL-36), fatigue level (Piper Fatigue Scale-PFS), sleep quality (Pittsburgh Sleep Quality Index-PSQI), anxiety, and depression (Hospital Anxiety and Depression Scale-HADS) were evaluated. Dialysis adequacy hemogram values were evaluated before treatment, one month later, and after treatment. Evaluations were performed by a blinded investigator who did not know which group the patients belonged to. After 8 weeks of training, there was a significant improvement in physical performance and fatigue levels in patients (p<0.05). While depression decreased significantly in both exercise groups (p<0.05), the decrease in anxiety levels was not significant (p>0.05). While the sleep quality PSQI total score decreased in both groups, subjective sleep quality and sleep disturbance decreased significantly only in the CSE group, and daytime dysfunction only in the AE group (p<0.05). In the KDQOL-36 sub-parameter scores, the burden of kidney disease improved in both groups; however, the effect of kidney disease improved only in the AE group, and the mental composite score improved only in the CSE group (p<0.05). In addition, it was found that the glucose value decreased and the fluid volume, sodium, phosphorus, and creatinine values increased significantly after exercise (p<0.05). When the amount of improvement achieved in both treatment groups was compared, a statistically significant increase was observed in the CSE group compared to the AE group only in the burden of kidney disease, one of the sub-parameters of the KDQOL-36 (p<0.05). There was no significant improvement in dialysis adequacy, either in the Kt/V value or in laboratory data (p>0.05). According to the results of this study, intradialytic core stabilization exercises have similar effects to aerobic exercises in HD patients and can be applied safely.