In our study, we wanted to raise awareness among health policy makers, dialysis and other chronic disease patients about the importance of daily physical activity in the fight against the consequences of the disease. The key contribution of the thesis is to determine whether an exercise programme where functional training is added to intra-dialytic cycling improves patients' capacity for activities of daily living compared to the currently widely used method of exercise with intra-dialytic cycling. We were also interested in the extent to which previous physical fitness and age influence the improvement of overall physical activity in dialysis patients.
The sample included 40 subjects with a diagnosis of end-stage kidney disease. All subjects were undergoing haemodialysis therapy at the University Medical Centre Ljubljana. The research instrument used was the Human Activity Profile Questionnaire (HAP). Subjects completed the questionnaire three times (before the start of the study, after 8 weeks and after 16 weeks). After the first, initial measurements, patients were randomly divided into an experimental (n=20) and a control (n=20) group. Both groups performed intra-dialytic cycling three times a week, while the experimental group also performed before dialysis 30–45 minutes of functional training three times a week. The statistical analysis included basic descriptive statistics, the Shapiro-Wilk test, paired t-test and the analysis of variance (ANOVA). Data were processed using SPSS 22.0 and Microsoft Excel 2013.
We found that there was an improvement in general physical activity and performance in both the experimental and control groups, however, no statistically significant differences were found between the groups. In addition, we found that the most statistically significant improvement in general physical activity was observed in the group considered as inactive at the beginning of the study, and the least improvement in the group considered as active. Finally, we found that age does not significantly affect the improvement of the adjusted activity score (AAS) of the HAP Questionnaire, but it does have a statistically significant effect on the maximum activity score (MAS) of the HAP Questionnaire.
We conclude that it would be useful to offer the possibility of intra-dialytic cycling and functional training to all dialysis patients treated in haemodialysis centres. Although we did not find statistically significant differences between the two exercise types, it would be helpful to include also functional training in the exercise programme as it is extremely important that patients develop strength, coordination, balance and flexibility in addition to aerobic capacity. Such an exercise programme would prevent additional comorbidities and complications associated with end-stage kidney failure. As a consequence, the quality of life of patients would be improved.
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