Effectiveness of Intradialytic Exercises on Selected Physiological Parameters and Fatigue among Patients Undergoing Hemodialysis at Selected Hospitals.

Abstract

Patients receiving hemodialysis experience of the structural and functional have alterations to their cardiovascular systems. Despite advancements in dialysis technology, cardiovascular mortality remains high. Patients undergoing hemodialysis have many challenges, which can stem from a range of factors, such as their disease state, food restrictions, psycho-social issues, behavioural issues, or even the process itself. Fatigue is one of the vital side effects that hemodialysis patients encounter. This study aimed to assess the effectiveness of intradialytic exercises on selected physiological parameters and fatigue among patients undergoing hemodialysis at selected hospitals.

The study used a quantitative research strategy as its research methodology. The research design adopted for the present study was a quasi-experimental, non-randomized, pre-test post-test control group design. The study's accessible population was made up of patient undergoing hemodialysis who had undergone more than 1 hemodialysis session, stable on hemodialysis, willing to participate, able to perform exercises and understood Marathi and English languages. There were 60 people in the sample (experimental group 30, control group 30) who were chosen using a non-probability convenience sampling technique by the inclusion criteria. The tool includes a structured questionnaire demographic data, a table for selected physiological parameters and Fatigue assessment scale used to measure fatigue.

Descriptive and inferential statistics were used in the data analysis. The paired t-test and two-sample t-test are used to find the effectiveness of intradialytic exercises on selected physiological parameters (such as heart rate, respiratory rate diastolic blood pressure, systolic blood pressure, SpO2) and fatigue among patients undergoing hemodialysis at selected hospitals. Fisher’s exact test is used to find the association between fatigue among patient undergoing hemodialysis and selected demographic variables.

Results:

In experimental group, in pretest, 10% of them had no fatigue, 73.3% of them had fatigue and 16.7% of them had extreme fatigue. In post-test, 33.3% of them had no fatigue and 63.3% of them had fatigue and 3.3% of them had extreme fatigue. In control group, in pretest, 16.7% of them had no fatigue, 70% of them had fatigue and 13.3% of them had extreme fatigue. In post-test, in pretest, 83.3% of them had fatigue and 16.7% of them had extreme fatigue. This indicates that fatigue among patients undergoing haemodialysis after intradialytic exercises.

In experimental group, average change in heart rate was 6.2 with standard deviation of 5.8 which was -3.7 in control group with standard deviation 6.8. T-value for this test was 6.1 with 58 degrees of freedom. Corresponding p-value was small (less than 0.05), null hypothesis is rejected. It is evident that the intradialytic exercises were significantly effective in improving the heart rate among patients undergoing hemodialysis.

In experimental group, average change in SpO₂ was 0.8% with standard deviation of 2.4% which was -0.5% in control group with standard deviation 1.7%. T-value for this test was 2.4 with 58 degrees of freedom. Corresponding p-value was small (less than 0.05), null hypothesis is rejected. It is evident that the intradialytic exercises were significantly effective in improving the SpO2 among patients undergoing hemodialysis.