The most commonly used method for the treatment of chronic kidney disease is hemodialysis. These patients usually have poorer motor skills and consequently balance problems, which can lead to unnecessary complications from falls. Adequate physical activity improves all motor skills in the general population, including balance.
The purpose of the master's thesis was to determine how exercise affects static and dynamic balance. Forty patients who were treated with hemodialysis at the University Clinical Center in Ljubljana took part in the research. They were randomly divided into control and experimental groups. Experimental group performed pre-dialysis functional exercise and intradialytic cycling. The control group performed intradialytic cycling only. Before starting the exercise program, we performed balance testing. We chose the stork's test to check static balance, and the functional range test to check dynamic balance. The control group performed aerobic training during hemodialysis, which included inter-dialysis cycling. The experimental group performed functional exercise training before the start of hemodialysis and then inter-dialysis cycling. After completing the training program, which was performed 3 times a week, total of 8 weeks, we performed balance testing again. We then collected and edited the data and compared them with the results of the testing that we carried out before the start of the training intervention.
Thirty-five patients completed the study. We compared the association between the two balance tests. Static balance is statistically significantly related to dynamic balance (p=0.006). The control group improved the functional reach result by 5 cm (p=0.008) and the stork test by 2.76 s (p=0.008). The experimental group also improved the result of the functional reach and stork test, by 12 cm (p<0.001) and 5.05 s (p<0.001). The results also showed that the interaction of time and group was statistically significant in the dynamic balance test (p=0.013), while the interaction of time and group was not statistically significant in the static balance test (p=0.295).
We found that both exercises improved balance in patients. Both static and dynamic balance has improved. Exercise performed by the experimental group, which included functional exercise before dialysis and cycling during dialysis, had a greater effect on improving dynamic balance. Physical exercise in hemodialysis patients effectively improves their balance, which in turn increases the health-related quality of life.
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