Musculoskeletal disorders are common in hemodialysis (HD) patients. The duration and frequency of HD procedures contribute to immobility and a sedentary lifestyle, which, combined with changes in the disease itself, affect frailty and fatigue. These changes can be reversed through the adoption of intradialytic exercise programs.

To investigate the effectiveness of resistance compared to aerobic exercise during the intradialytic period on peripheral muscle strength, walking speed, frailty, and fatigue in patients with chronic kidney disease.

In this randomized controlled trial, 32 patients were randomly allocated into two groups: Resistance exercise group (Group A), that included 8 exercises using elastic bands, dumbbells, and a Swiss ball, with 2 sets of 8 to 12 repetitions, an interval of 2 to 3 minutes between sets, and an intensity of 6 on the modified OMNI scale; and Aerobic exercise group (Group B), which consisted of 20 minutes of exercise on a cycle ergometer at an intensity between 5 and 7 on the modified Borg scale. All intervention protocols were performed during the first 90 minutes of hemodialysis, with the patient seated in a reclined chair. Peripheral muscle strength was assessed using the Sahean handgrip dynamometer and the 30-second sit-to-stand test; gait speed and frailty were assessed using the Fried Phenotype Model, and fatigue was evaluated using the Multidimensional Fatigue Inventory (MFI-20). The assessment of data normality was performed through visual inspection of histograms. The linear mixed model was used for intra and intergroup analyses. The level of statistical significance was set at 5%.

Group A performed an average of 31.4 (±3.4) effective exercise sessions and Group B performed an average of 32.5 (±3.5) effective exercise sessions. There was no significant differences, between groups, in the results of 30-second sit-to-stand test (Group A, pre: 10.1 ± 2.0 and post: 14.9 ±4.2; Group B, pre: 10 ± 2.3 and post: 16.2 ± 2.7), handgrip strength test (HST) (Group A - pre: 25.7 ± 8.7 kgf and post: 28.1 ± 9.7kgf; Group B - pre: 29.1 ± 9.4kgf and post: 29.6 ±8.70kgf), and gait speed test (Group A - pre: 1.00 ± 0.20 m/s and post: 1.3 ± 0.3 m/s; Group B - pre: 1.1 ± 0.1 m/s and post: 1.5 ± 0.2 m/s). There was a decrease in the number of frail patients in both groups (18.8%), but no significant differences were observed between groups for the total fatigue score (Group A - pre: 55.9 ± 6.2 and post: 55.6 ± 7.9; Group B - pre: 58.9 ± 6.6 and post: 56.6 ± 8.8).

No significant differences were observed between intradialytic exercise interventions in terms of peripheral muscle strength, walking speed, frailty, and fatigue. It is suggested that further studies can be conducted on the subject, in addition to the inclusion of variables such as pain, which may influence the results of the outcomes studied here.

Regardless of the type of exercise performed during hemodialysis, patients with chronic kidney disease can have positive effects on muscle strength, walking speed, frailty, and fatigue.