Share this Article
Maniam R, Subramanian P, Singh SK, Lim SK, Chinna K, Rosli R
Correspondence: Dr Pathmawathi Subramanian, pathmawathi@um.edu.my
ABSTRACT
INTRODUCTION Fatigue and quality of sleep are the main factors that contribute to a poor quality of life among patients on long-term haemodialysis. Studies have also emphasised the importance of exercise for improving the wellbeing of dialysis patients. This study aimed to determine the effectiveness of a predialysis low-to-moderate-intensity exercise programme for reducing fatigue and improving sleep disorders among long-term haemodialysis patients.
METHODS In this quasi-experimental study, an exercise programme was conducted three times a week for 12 weeks before long-term haemodialysis patients underwent dialysis at two centres. The patients were categorised into either the exercise group (n = 28) or control group (n = 27). The latter was asked to maintain their current lifestyles. Assessments of fatigue and sleep disorder levels were performed for both groups using self-reported questionnaires at baseline and after intervention. The patients’ perception of the exercise programme was also determined using self-reported questionnaires.
RESULTS Paired sample t-test indicated improvements in fatigue level in the exercise group (mean fatigue score: post-treatment 40.5 ± 7.9 vs. pre-treatment 30.0 ± 10.9). Improvements in sleep disorders were also observed in the exercise group (mean score: post-treatment 7.6 ± 3.3 vs. pre-treatment 10.1 ± 3.8). However, sleep quality deteriorated in the control group (mean score: post-treatment 10.7 ± 2.9 vs. pre-treatment 9.3 ± 2.9).
CONCLUSION Simple low-to-moderate-intensity exercise is effective for improving fatigue, sleep disorders and the overall quality of life among haemodialysis patients.
Keywords: exercise, fatigue, haemodialysis, sleep disorder
Singapore Med J 2014; 55(9): 476-482; http://dx.doi.org/10.11622/smedj.2014119
REFERENCES
| 1. Bonner A, Wellard S, Caltabiano M. The impact of fatigue on daily activity in people with chronic kidney disease. J Clin Nurs. 2010; 19:3006-15. http://dx.doi.org/10.1111/j.1365-2702.2010.03381.x | ||||
| 2. Li M, Li L, Fan X. Patients Having Hemodialysis: Physical Activity and Associated Factors. J Adv Nurs. 2010; 66:1338-45. http://dx.doi.org/10.1111/j.1365-2648.2010.05283.x | ||||
| 3. McCann K, Boore JRP. Fatigue in person with renal failure who require maintenance hemodialysis. J Adv Nurs. 2000; 32:1132-42. http://dx.doi.org/10.1046/j.1365-2648.2000.01584.x | ||||
| 4. O'Sullivan D, McCarthy G. An Exploration of relationship between fatigue and physical functioning in patients with end stage renal disease receiving hemodialysis. J Clin Nurs. 2007; 16:276-84. http://dx.doi.org/10.1111/j.1365-2702.2007.01965.x | ||||
| 5. Cupisiti A, Capitanini A, Betti G, D'Alessandro C, Barsotti G. Assessment of Habitual Physical Activity and Energy Expenditure in Dialysis Patients and Relationships to Nutritional Parameters. Clin Nephro. 2011; 75:3218?225. | ||||
| 6. Wong HS, Ong LM. Death And Survival On Dialysis: 18th Report of The Malaysian Dialysis and Transplant Registry.: The Malaysian Dialysis and Transplant Registry 2010. | ||||
| 7. Painter P, Carlson L, Carey S, Paul SM, Myll J. Physical Functioning and Health-Related Qulaity of Life Changes with Exercise Training in Hemodialysis Patients. Am J Kidney Dis. 2000; 35:482-92. http://dx.doi.org/10.1016/S0272-6386(00)70202-2 | ||||
| 8. Stack AG, Murthy B. Exercise and Limitations in Physical Activity Levels among New Dialysis Patients in the United States: An Epidemiologic Study. Am J Epid. 2008; 18:880-8. | ||||
| 9. Stamatakis E, Hamer M. Sedentary Behavior: Redefining its Meaning and Links to Chronic Diseases. Brit J Hosp Med. 2011; 72:192-5. http://dx.doi.org/10.12968/hmed.2011.72.4.192 | ||||
| 10. Chang Y, Cheng S-Y, Lin M, Gau F-Y, C. Chao Y-F. The effectiveness of intradialytic leg ergometry exercise for improving sedentary life style and fatigue among patients with chronic kidney disease: A randomized clinical trial. Int J Nurs Stud. 2010; 47:1383-8. http://dx.doi.org/10.1016/j.ijnurstu.2010.05.002 | ||||
| 11. Webster K, Cella D, Yost K. The functional assessment of chronic illness therapy (FACIT) measurement system: properties, applications and interpretation. Health Qual Life Outcomes. 2003; 1:1-7. http://dx.doi.org/10.1186/1477-7525-1-79 | ||||
| 12. Borg GA. Psychophysical bases of percieved exertion. Med sci sports exerc. 1982; 14:377-81. http://dx.doi.org/10.1249/00005768-198205000-00012 | ||||
| 13. Cella D, Lai JS, Chang CH, Peterman A, Slavin M. Fatigue in cancer patients compared with fatigue in general population. Am Ca Society. 2002; 94:528-38. | ||||
| 14. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psyc Res. 1989; 28:193-213. http://dx.doi.org/10.1016/0165-1781(89)90047-4 | ||||
| 15. Edmunds J, Ntoumanis N, Duda JL. A Test of Self-Determination Theory in the Exercise Domain. J Applied Soc Psy. 2006; 36:2240-65. http://dx.doi.org/10.1111/j.0021-9029.2006.00102.x | ||||
| 16. Lim YN, Ghazali A, Tan CC, Lee DG. Dialysis in Malaysia: 18th Report of The Malaysian Dilaysis and Transplant Registry 2010. Kuala Lumpur: Malaysia: Malaysian Society of Nephrology, 2011. | ||||
| 17. Karavatas SG, Tavakol K. Concurrent validity of borg's rating of perceived exertion in African-American young adults, employing heart rate as the standard. Internet J Allied Health Sciences Pract January 2005, Vol 3, No. 1. | ||||
| 18. Yusop NB, Yoke MC, Shariff ZM, Beng HC. Factors Associated with Quality of Life among Hemodialysis Patients in Malaysia. PLoS ONE. 2013; 8:e84152. http://dx.doi.org/10.1371/journal.pone.0084152 | ||||
| 19. Olson K. A New Way of Thinking about Fatigue: A Reconceptualization. Onco Nurs Forum. 2007; 34:93-9. http://dx.doi.org/10.1188/07.ONF.93-99 | ||||
| 20. Santhana L, Srijit D, Hasliza H, et al. Fatigue Experienced by Patients Receiving Maintenance Dialysis in Hemodialysis Units. Nurs Health Sciences. 2011:60-4. | ||||
| 21. Merlino G, Piani A, Dolso P, et al. Sleep Disorders in patients with end-stage renal disease undergoing dialysis therapy. Nephrol Dial Transp. 2005; 21:184?90. http://dx.doi.org/10.1093/ndt/gfi144 | ||||
| 22. Sklar AH, Riesenberg LA, Silber AK, Wagar A, Amir A. Postdialysis Fatigue. Am J Kidney Dis. 1996; 28:732-5. http://dx.doi.org/10.1016/S0272-6386(96)90256-5 | ||||
| 23. Yurtkuran M, Alp A, Yutkuran M, Dilek K. A modified yoga-based exercise program in hemodialysis patints: a randomized controlled study. Comp Therapies Med. 2007; 65:164-71. http://dx.doi.org/10.1016/j.ctim.2006.06.008 | ||||
| 24. Malagoni AM, Catizane L, Mandini S, et al. Acute and long term effects of an exercise program for dialysis patients prescribed in hospital and performed at home. J Nephrol. 2008; 21:871-8. PMid:19034871 | ||||
| 25. Reza A, Abbas E, Nader S, Sanavi S. Effects of Interdialytic Aerobic Training on Sleep Quality in Hemodialysis Patients. J Kidney Dis. 2011; 5:119-23. | ||||
| 26. van Vilsteren MCBA, Greef MHGd, Huisman RM. The effects of a low-to-moderate intensity pre-conditioning exercise program linked with exercise counseling for sedentary haemodialysis patients in The Netherlands: results of a randomized clinical trial. Nephrol Dialysis Transp. 2004; 20:141-6. http://dx.doi.org/10.1093/ndt/gfh560 | ||||
| 27. Cheema BSB, Singh MAF. Exercise training in patients receiving maintenance hemodialysis: a systematic review of clinical trials. Am J Kidney Dis. 2005; 25:352- 64. | ||||
| 28. Ryan RM, Deci EL. Intrinsic and Extrinsic Motivations: Classic Definitions and New Directions. Contemp Edu Psycho. 2000; 25:54-67. http://dx.doi.org/10.1006/ceps.1999.1020 | ||||