Patients undergoing hemodialysis are often physicaly inactive and experience decreased physical performance compared to the general population. Additionally, cognitive impairments are frequently present in this population but often overlooked. The effects of physical exercise in hemodialysis patients have been investigated in several studies, while cognitive interventions in this population are scarce.
The aim of this master's thesis was to examine the effects of combined interdialytic cognitive training and physical exercise on cognitive abilities and physial performance in the hemodialysis population.
A total of 44 hemodialysis patients were randomly assigned to an experimental group (n = 22) and a control group (n = 22). The intervention lasted for 12 weeks. The experimental group performed interdialytic cycling and cognitive training on the Cognifit platform using the tablet computers three times a week. The control group received standard care only. The effects of the intervention were assessed using the Timed up and Go test (TUG) and the Symbol Digit Modalities Test (SDMT).
The study was compleated by 42 patients. In the experimental group, we observed an improvement in TUG test performance by 0,84 seconds (p < 0,001) and an increase in SDMT test scores by 1,18 points (p < 0,001). Furthermore, significant improvements compared to the control group were found in both the TUG test (p = 0,005) and the SDMT test (p < 0,001). A shorter time to compleate the TUG test was associated with better performance on the SDMT test (r = -0,497, p = 0,001).
The combination of interdialytic exercise and cognitive training improved both physical performance and cognitivne abilities. Given the high prevalence and burden of cognitive decline in this population, guidelines for the management of hemodialysis patients should consider incorporating cognitive and physical interventions.
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