Table 3.

Summary of study interventions and results

First Author (Yr)InterventionFreq (/wk)Goal Intensity (Session Length)Duration (wk)ComparatorMeasurement Tool (Primary or Secondary Outcome)Mean ChangeDirection and P Value
Control (SD)Exercise (SD)
Restless legs syndrome
 Giannaki et al. (14)Intradialytic cycling360%–65% max exercise capacity (45 min)26Placebo pillsIRLS (primary)−1.1 (8.4)−13.1 (8.6)+ exercise P=0.009
 Mortazavi et al. (17)Intradialytic cycling3Borg RPE 10–12 (30 min)16Usual careIRLS (primary)−0.5 (2.3)−5.5 (5.0)+ exercise P=0.003
Sleep disturbance
 Afshar et al. (22)Intradialytic cycling3Borg RPE 12–15 65%–85% max exercise capacity (10–30 min)8Usual carePSQI (primary)1.0 (1.0)−5.9 (2.6)+ exercise P<0.001
 Cho et al. (25)Intradialytic cycling3Borg RPE 11–13 (30 min)12Warm-up stretchesSleep Accelerometry (primary)
a. TSTb. WASO (min) c. SE8.0 (63.0) 4.0 (9.0)–1.0 (2.8)17.0(104.0) 1.0 (12.0)–0.2 (1.7)P>0.05 P>0.05 P>0.05
 Giannaki et al.(14)Intradialytic cycling360%–65% of max exercise capacity (45 min)26Placebo pillsSleep diary (secondary)0.4 (2.7)−0.7 (3.2)P>0.05
 Poorsadet et al. (30)Intradialytic cycling3Borg RPE 12–14 (75 min)24?PSQI (secondary)4.1 (3.5)−2.9 (2.3)+ exercise P=0.001, control P=0.35
Anxiety
 Carmack et al. (23)Intradialytic cycling3(20–30 min)10Attention (positive social conversation 3–5 min 3× weekly with experimenters)STAI (secondary)−1.3 (2.6)−2.1 (4.6)P>0.05
 Frih et al. (26)Extradialytic combined cycling, treadmill walking and resistance exercise4Borg scale of 5–6 for dyspnea or fatigue (30 min) 12–15 reps of five strength exercises (total 60 min)17Usual careHADS (secondary)ES−1.7 (95% CI, −2.4 to 1.3)+ exercise
 Goldberg et al. (27)Extradialytic stationary cycling, walking, and jogging350%–80% VO2 max (45–60 min)26Usual CareMAACL (secondary) controls worse exercise no change P>0.05
 Kouidi et al. (16)Intradialytic cycling and resistance exercise3Borg RPE 11–13 (30–60 min); Resistance (20 min)52Usual careHADS (anxiety and depression subscales not separated in HADS) (secondary)−0.05 (0.73)−2.6 (0.7)+ exercise P<0.001
Depression
 Carmack et al. (23)Intradialytic cycling3(20–30 min)10Attention (positive social conversation 3–5 min 3×weekly with experimenters)CES-D (secondary)−3.0 (2.7)−5.1 (4.5)No change
 Carney (1987) (24)Extradialytic walking, jogging, stationary cycling, and calisthenics350%–80% VO2 max (30–60 min)26Attention (psychologist-led support group 60–90 min 1–2×weekly for 24 wk)BDI (primary)2.5a−4.3a+ exercise P<0.05
 Frih (2017) (26)Extradialytic combined aerobic and resistance exercise4Borg scale of 5–6 for dyspnea or fatigue (30 min) 12–15 reps of 5 strength exercises (total 60 min)17Usual careHADS (secondary)ES−2.7 (95% CI: −3.5 to −1.86)+ exercise
 Giannaki et al. (14)Intradialytic cycling360%–65% of max exercise capacity (45 min)26Placebo pillsZung SDS (secondary)5.9 (6.4)−8.3 (7.9)+ exercise P=0.002
 Goldberg et al. (27)Extradialytic stationary cycling, walking, and jogging350%–80% VO2 max (45–60 min)26Usual CareBDI (secondary)controls no change; +exercise P<0.05
 Kouidi et al. (28)Extradialytic cycling, walking/jogging, calisthenics, aerobics, swimming or sports350%–60% VO2 max or 60%–70% HR max (90 min)26Usual careBDI (Secondary)−0.4 (4.8)−7.3 (3.1)+ exercise P<0.05
 Kouidi et al. (16)Intradialytic cycling and resistance3Cycling: Borg RPE 11–13 (30–60 min); resistance: 20 min; warm up: 5 mins; cool down: 5 mins52Usual careBDI (secondary)−0.20 (2.1)−7.7 (1.6)+ exercise P<0.001
 Ouzouni et al. (29)Intradialytic cycling and resistance3Borg RPE 13–14 (30–60 min cycling; 30 min of strength and stretching)43Usual careBDI (secondary)0.2 (1.4)−7.6 (1.4)+ exercise P<0.05
 van Vilsteren et al. (31)Intradialytic cycling and predialysis strength training3Cycling approximately 60% HR max (20–30 min cycling); strength 5–10 min warm up, 20 min exercise, 5–10 min cool down12Usual careZung SDS (secondary)2.4 (2.0)1.0 (1.6)No change P=0.40
Cramping
 Jazi and Aliasgharpour (15)Walking (postdialysis)310 min fast walking (as fast as patient can tolerate), 5 min warm up, 5 min cool down (slow walking)8Usual careCramps improved (primary)31%83%+ exercise P=0.01
Fatigue
 Salehi et al. (32)Intradialytic cycling220 min cycling at low power at 30 rpm during the first 2 h of every dialysis session12Usual careMFI (primary)7.0 (4.5)−4.60 (4.8)+ exercise P=0.001
  • IRLS, International Restless Legs Syndrome Severity Scale; RPE, rating of perceived exertion; PSQI, Pittsburgh Sleep Quality Index; TST, total sleep time; WASO, wake after sleep onset; SE, sleep efficiency; STAI, State-Trait Anxiety Inventory; HADS, Hospital Anxiety and Depression Scale; ES, effect size; 95% CI, 95% confidence interval; MAACL, Multiple Affect Adjective Checklist; CES-D, Center of Epidemiologic Studies Depression Scale; VO2 max, maximum oxygen uptake; BDI, Beck’s Depression Inventory; SDS, Self-Rated Depression Scale; HR, heart rate; rpm, revolutions per minute; MFI, Multidimensional Fatigue Inventory.

  • a Standard deviation for within group mean change not available.