Main Article Content
Abstract
Introduction:Prolonged exposure to hemodialysis treatments has a catabolic effect on muscles also compounding this expedited muscle loss associated decrease quality of life. The aim of this study is to investigate the benefits of intradialytic exercise programs, specifically on increase muscle strength and physical function. Methods: search in PubMed, ProQuest, and MEDLINE (EBSCO) about intervention intradialytic exercise program of CRF patients impairment muscle strength. Studies included intradialytic exercise program randomized controlled trials study design. Result: Most studies included in this review focused on intradialytic exercise program. These intervention program seems to increase muscle strength and improved physical function, and less decline in muscle cramp. Conclusion: Patients with CRF on hemodialysis need to do intradialytic exercise program. In addition, standardization of intradialytic exercise program, outcome and evaluation for patients with CRF on hemodialysis especially on muscle strength and muscle cramp, muscle mass, physically function is needed for further studies.
Keywords
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Copyright @2017. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted non-commercial used, distribution and reproduction in any medium
References
- Anding, K., Bär, T., Trojniak-Hennig, J., Kuchinke, S., Krause, R., Rost, J. M., & Halle, M. (2015). A structured exercise programme during haemodialysis for patients with chronic kidney disease: Clinical benefit and long-term adherence. BMJ Open, 5(8), 1–9. https://doi.org/10.1136/bmjopen-2015-008709
- Carletti, C. O., Rosa, C. S. da C., Souza, G. D. e, Ramirez, A. P., Daibem, C. G. L., & Monteiro, H. L. (2017). Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis. Fisioterapia Em Movimento, 30(2), 247–254. https://doi.org/10.1590/1980-5918.030.002.ao05
- Chan, C. T., Blankestijn, P. J., Dember, L. M., Gallieni, M., Harris, D. C. H., Lok, C. E., … Cheung, M. (n.d.). Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. 1–11. https://doi.org/10.1016/j.kint.2019.01.017
- Chan, K. N., Chen, Y., Lit, Y., Massaband, P., Kiratli, J., Rabkin, R., & Myers, J. N. (2019). A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample. Contemporary Clinical Trials Communications, 15(November 2018), 100365. https://doi.org/10.1016/j.conctc.2019.100365
- Dong, Z. J., Zhang, H. L., & Yin, L. X. (2019). Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial. International Urology and Nephrology, 51(8), 1415–1424. https://doi.org/10.1007/s11255-019-02200-7
- Esgalhado, M., Stockler-Pinto, M. B., De França Cardozo, L. F. M., Costa, C., Barboza, J. E., & Mafra, D. (2015). Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients. Kidney Research and Clinical Practice, 34(1), 35–40. https://doi.org/10.1016/j.krcp.2015.02.004
- Hsu, H. J., Yen, C. H., Hsu, K. H., Wu, I. W., Lee, C. C., Hung, M. J., … Wu, M. S. (2014). Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease. BMC Nephrology, 15(1). https://doi.org/10.1186/1471-2369-15-6
- J, M. L., Abraham, D. E. J., & Malarvizhi, D. G. (2017). Effectiveness of Intradialytic Stretching Exercises on Prevention and Reduction of Muscle Cramps among Patients undergoing Haemodialysis at PSG Hospitals Coimbatore. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602044753
- Lopes, L. C. C., Mota, J. F., Prestes, J., Schincaglia, R. M., Silva, D. M., Queiroz, N. P., … Peixoto, M. do R. G. (2019). Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial. Archives of Physical Medicine and Rehabilitation, 100(11), 2151–2158. https://doi.org/10.1016/j.apmr.2019.06.006
- Manfredini, F., Mallamaci, F., Arrigo, G. D., Baggetta, R., Bolignano, D., Torino, C., … Elhafeez, S. A. (2017). Exercise in Patients on Dialysis : A Multicenter , Randomized Clinical Trial. 1259–1268. https://doi.org/10.1681/ASN.2016030378
- Martins do Valle, F., Valle Pinheiro, B., Almeida Barros, A. A., Ferreira Mendonça, W., de Oliveira, A. C., de Oliveira Werneck, G., … Moura Reboredo, M. (2019). Effects of intradialytic resistance training on physical activity in daily life, muscle strength, physical capacity and quality of life in hemodialysis patients: a randomized clinical trial. Disability and Rehabilitation, 0(0), 1–7. https://doi.org/10.1080/09638288.2019.1606857
- Mohammad Abd Elbaky, M., Mohammed Zaki, S., Mohammed Amin, N., & Mohammed Nagib Ali, R. (2018). Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients. American Journal of Nursing Research, 6(5), 263–272. https://doi.org/10.12691/ajnr-6-5-7
- arker, K. (2016). Intradialytic Exercise is Medicine for Hemodialysis Patients. Current Sports Medicine Reports, 15(4), 269–275. https://doi.org/10.1249/JSR.0000000000000280
- Po, J., & Parimala, S. (2020). Assess the Effect of Intradialytic Stretching Exercises to Reduce Leg Muscle Cramps among Patients Undergoing Hemodialysis in Selected Dialysis Unit of Ernakulum District. 6(2), 1–6.
- Poornazari, M., Dehghani, K., Shahbazi, S., & Khaledi Sardashti, F. (2017). Impact of a designed isotonic exercise program on pain intensity of muscle cramps in legs of patients undergoing hemodialysis; a randomized clinical trial. Journal of Nephropharmacology, 6(2), 85–89. https://doi.org/10.15171/npj.2017.10
- Poornazari, M., Roshanzadeh, M., Parsa, S., & Tajabadi, A. (2019). Effect of Isotonic Exercise on the Frequency of Muscle Cramps in Hemodialysis Patients : A Clinical Trial. 8(1), 1–5. https://doi.org/10.5812/msnj.85770.Research
- Anding, K., Bär, T., Trojniak-Hennig, J., Kuchinke, S., Krause, R., Rost, J. M., & Halle, M. (2015). A structured exercise programme during haemodialysis for patients with chronic kidney disease: Clinical benefit and long-term adherence. BMJ Open, 5(8), 1–9. https://doi.org/10.1136/bmjopen-2015-008709
- Carletti, C. O., Rosa, C. S. da C., Souza, G. D. e, Ramirez, A. P., Daibem, C. G. L., & Monteiro, H. L. (2017). Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis. Fisioterapia Em Movimento, 30(2), 247–254. https://doi.org/10.1590/1980-5918.030.002.ao05
- Chan, C. T., Blankestijn, P. J., Dember, L. M., Gallieni, M., Harris, D. C. H., Lok, C. E., … Cheung, M. (n.d.). Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. 1–11. https://doi.org/10.1016/j.kint.2019.01.017
- Chan, K. N., Chen, Y., Lit, Y., Massaband, P., Kiratli, J., Rabkin, R., & Myers, J. N. (2019). A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample. Contemporary Clinical Trials Communications, 15(November 2018), 100365. https://doi.org/10.1016/j.conctc.2019.100365
- Dong, Z. J., Zhang, H. L., & Yin, L. X. (2019). Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial. International Urology and Nephrology, 51(8), 1415–1424. https://doi.org/10.1007/s11255-019-02200-7
- Esgalhado, M., Stockler-Pinto, M. B., De França Cardozo, L. F. M., Costa, C., Barboza, J. E., & Mafra, D. (2015). Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients. Kidney Research and Clinical Practice, 34(1), 35–40. https://doi.org/10.1016/j.krcp.2015.02.004
- Hsu, H. J., Yen, C. H., Hsu, K. H., Wu, I. W., Lee, C. C., Hung, M. J., … Wu, M. S. (2014). Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease. BMC Nephrology, 15(1). https://doi.org/10.1186/1471-2369-15-6
- J, M. L., Abraham, D. E. J., & Malarvizhi, D. G. (2017). Effectiveness of Intradialytic Stretching Exercises on Prevention and Reduction of Muscle Cramps among Patients undergoing Haemodialysis at PSG Hospitals Coimbatore. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602044753
- Lopes, L. C. C., Mota, J. F., Prestes, J., Schincaglia, R. M., Silva, D. M., Queiroz, N. P., … Peixoto, M. do R. G. (2019). Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial. Archives of Physical Medicine and Rehabilitation, 100(11), 2151–2158. https://doi.org/10.1016/j.apmr.2019.06.006
- Manfredini, F., Mallamaci, F., Arrigo, G. D., Baggetta, R., Bolignano, D., Torino, C., … Elhafeez, S. A. (2017). Exercise in Patients on Dialysis : A Multicenter , Randomized Clinical Trial. 1259–1268. https://doi.org/10.1681/ASN.2016030378
- Martins do Valle, F., Valle Pinheiro, B., Almeida Barros, A. A., Ferreira Mendonça, W., de Oliveira, A. C., de Oliveira Werneck, G., … Moura Reboredo, M. (2019). Effects of intradialytic resistance training on physical activity in daily life, muscle strength, physical capacity and quality of life in hemodialysis patients: a randomized clinical trial. Disability and Rehabilitation, 0(0), 1–7. https://doi.org/10.1080/09638288.2019.1606857
- Mohammad Abd Elbaky, M., Mohammed Zaki, S., Mohammed Amin, N., & Mohammed Nagib Ali, R. (2018). Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients. American Journal of Nursing Research, 6(5), 263–272. https://doi.org/10.12691/ajnr-6-5-7
- Parker, K. (2016). Intradialytic Exercise is Medicine for Hemodialysis Patients. Current Sports Medicine Reports, 15(4), 269–275. https://doi.org/10.1249/JSR.0000000000000280
- Po, J., & Parimala, S. (2020). Assess the Effect of Intradialytic Stretching Exercises to Reduce Leg Muscle Cramps among Patients Undergoing Hemodialysis in Selected Dialysis Unit of Ernakulum District. 6(2), 1–6.
- Poornazari, M., Dehghani, K., Shahbazi, S., & Khaledi Sardashti, F. (2017). Impact of a designed isotonic exercise program on pain intensity of muscle cramps in legs of patients undergoing hemodialysis; a randomized clinical trial. Journal of Nephropharmacology, 6(2), 85–89. https://doi.org/10.15171/npj.2017.10
- Poornazari, M., Roshanzadeh, M., Parsa, S., & Tajabadi, A. (2019). Effect of Isotonic Exercise on the Frequency of Muscle Cramps in Hemodialysis Patients : A Clinical Trial. 8(1), 1–5. https://doi.org/10.5812/msnj.85770.Research
- Salem, S. S., & Elhadary, S. M. (2017). Effectiveness of Intra-dialytic Stretching Exercises on Leg Muscle Cramp among Hemodialysis Patients. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602094753
- Wilkinson, T. J., Watson, E. L., Gould, D. W., Xenophontos, S., Clarke, A. L., Vogt, B. P., … Smith, A. C. (2019). Twelve weeks of supervised exercise improves self-reported symptom burden and fatigue in chronic kidney disease: A secondary analysis of the “ExTra CKD” trial. Clinical Kidney Journal, 12(1), 113–121. https://doi.org/10.1093/ckj/sfy071
- Zelko, A., Skoumalova, I., Kolarcik, P., Rosenberger, J., Rabajdova, M., Marekova, M., … Reijneveld, S. A. (2019). The effects of intradialytic resistance training on muscle strength, psychological well-being, clinical outcomes and circulatory micro-ribonucleic acid profiles in haemodialysis patients: Protocol for a quasi-experimental study. Medicine, 98(19), e15570. https://doi.org/10.1097/MD.0000000000015570
- Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self- management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. 1–14
- Yin, X. (2005). Understanding the factors influencing diabetes self-management in chinese people with type 2 diabetes using structural equation modeling. (Order No. 3196957, University of Cincinnati). ProQuest Dissertations and Theses, , 162-162 p. Retrieved from http://search.proquest.com/docview/305004492?accountid=17242
References
Anding, K., Bär, T., Trojniak-Hennig, J., Kuchinke, S., Krause, R., Rost, J. M., & Halle, M. (2015). A structured exercise programme during haemodialysis for patients with chronic kidney disease: Clinical benefit and long-term adherence. BMJ Open, 5(8), 1–9. https://doi.org/10.1136/bmjopen-2015-008709
Carletti, C. O., Rosa, C. S. da C., Souza, G. D. e, Ramirez, A. P., Daibem, C. G. L., & Monteiro, H. L. (2017). Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis. Fisioterapia Em Movimento, 30(2), 247–254. https://doi.org/10.1590/1980-5918.030.002.ao05
Chan, C. T., Blankestijn, P. J., Dember, L. M., Gallieni, M., Harris, D. C. H., Lok, C. E., … Cheung, M. (n.d.). Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. 1–11. https://doi.org/10.1016/j.kint.2019.01.017
Chan, K. N., Chen, Y., Lit, Y., Massaband, P., Kiratli, J., Rabkin, R., & Myers, J. N. (2019). A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample. Contemporary Clinical Trials Communications, 15(November 2018), 100365. https://doi.org/10.1016/j.conctc.2019.100365
Dong, Z. J., Zhang, H. L., & Yin, L. X. (2019). Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial. International Urology and Nephrology, 51(8), 1415–1424. https://doi.org/10.1007/s11255-019-02200-7
Esgalhado, M., Stockler-Pinto, M. B., De França Cardozo, L. F. M., Costa, C., Barboza, J. E., & Mafra, D. (2015). Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients. Kidney Research and Clinical Practice, 34(1), 35–40. https://doi.org/10.1016/j.krcp.2015.02.004
Hsu, H. J., Yen, C. H., Hsu, K. H., Wu, I. W., Lee, C. C., Hung, M. J., … Wu, M. S. (2014). Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease. BMC Nephrology, 15(1). https://doi.org/10.1186/1471-2369-15-6
J, M. L., Abraham, D. E. J., & Malarvizhi, D. G. (2017). Effectiveness of Intradialytic Stretching Exercises on Prevention and Reduction of Muscle Cramps among Patients undergoing Haemodialysis at PSG Hospitals Coimbatore. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602044753
Lopes, L. C. C., Mota, J. F., Prestes, J., Schincaglia, R. M., Silva, D. M., Queiroz, N. P., … Peixoto, M. do R. G. (2019). Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial. Archives of Physical Medicine and Rehabilitation, 100(11), 2151–2158. https://doi.org/10.1016/j.apmr.2019.06.006
Manfredini, F., Mallamaci, F., Arrigo, G. D., Baggetta, R., Bolignano, D., Torino, C., … Elhafeez, S. A. (2017). Exercise in Patients on Dialysis : A Multicenter , Randomized Clinical Trial. 1259–1268. https://doi.org/10.1681/ASN.2016030378
Martins do Valle, F., Valle Pinheiro, B., Almeida Barros, A. A., Ferreira Mendonça, W., de Oliveira, A. C., de Oliveira Werneck, G., … Moura Reboredo, M. (2019). Effects of intradialytic resistance training on physical activity in daily life, muscle strength, physical capacity and quality of life in hemodialysis patients: a randomized clinical trial. Disability and Rehabilitation, 0(0), 1–7. https://doi.org/10.1080/09638288.2019.1606857
Mohammad Abd Elbaky, M., Mohammed Zaki, S., Mohammed Amin, N., & Mohammed Nagib Ali, R. (2018). Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients. American Journal of Nursing Research, 6(5), 263–272. https://doi.org/10.12691/ajnr-6-5-7
arker, K. (2016). Intradialytic Exercise is Medicine for Hemodialysis Patients. Current Sports Medicine Reports, 15(4), 269–275. https://doi.org/10.1249/JSR.0000000000000280
Po, J., & Parimala, S. (2020). Assess the Effect of Intradialytic Stretching Exercises to Reduce Leg Muscle Cramps among Patients Undergoing Hemodialysis in Selected Dialysis Unit of Ernakulum District. 6(2), 1–6.
Poornazari, M., Dehghani, K., Shahbazi, S., & Khaledi Sardashti, F. (2017). Impact of a designed isotonic exercise program on pain intensity of muscle cramps in legs of patients undergoing hemodialysis; a randomized clinical trial. Journal of Nephropharmacology, 6(2), 85–89. https://doi.org/10.15171/npj.2017.10
Poornazari, M., Roshanzadeh, M., Parsa, S., & Tajabadi, A. (2019). Effect of Isotonic Exercise on the Frequency of Muscle Cramps in Hemodialysis Patients : A Clinical Trial. 8(1), 1–5. https://doi.org/10.5812/msnj.85770.Research
Anding, K., Bär, T., Trojniak-Hennig, J., Kuchinke, S., Krause, R., Rost, J. M., & Halle, M. (2015). A structured exercise programme during haemodialysis for patients with chronic kidney disease: Clinical benefit and long-term adherence. BMJ Open, 5(8), 1–9. https://doi.org/10.1136/bmjopen-2015-008709
Carletti, C. O., Rosa, C. S. da C., Souza, G. D. e, Ramirez, A. P., Daibem, C. G. L., & Monteiro, H. L. (2017). Intradialytic exercise and postural control in patients with chronic kidney disease undergoing hemodialysis. Fisioterapia Em Movimento, 30(2), 247–254. https://doi.org/10.1590/1980-5918.030.002.ao05
Chan, C. T., Blankestijn, P. J., Dember, L. M., Gallieni, M., Harris, D. C. H., Lok, C. E., … Cheung, M. (n.d.). Dialysis initiation, modality choice, access, and prescription: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. 1–11. https://doi.org/10.1016/j.kint.2019.01.017
Chan, K. N., Chen, Y., Lit, Y., Massaband, P., Kiratli, J., Rabkin, R., & Myers, J. N. (2019). A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample. Contemporary Clinical Trials Communications, 15(November 2018), 100365. https://doi.org/10.1016/j.conctc.2019.100365
Dong, Z. J., Zhang, H. L., & Yin, L. X. (2019). Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: a randomized controlled trial. International Urology and Nephrology, 51(8), 1415–1424. https://doi.org/10.1007/s11255-019-02200-7
Esgalhado, M., Stockler-Pinto, M. B., De França Cardozo, L. F. M., Costa, C., Barboza, J. E., & Mafra, D. (2015). Effect of acute intradialytic strength physical exercise on oxidative stress and inflammatory responses in hemodialysis patients. Kidney Research and Clinical Practice, 34(1), 35–40. https://doi.org/10.1016/j.krcp.2015.02.004
Hsu, H. J., Yen, C. H., Hsu, K. H., Wu, I. W., Lee, C. C., Hung, M. J., … Wu, M. S. (2014). Factors associated with chronic musculoskeletal pain in patients with chronic kidney disease. BMC Nephrology, 15(1). https://doi.org/10.1186/1471-2369-15-6
J, M. L., Abraham, D. E. J., & Malarvizhi, D. G. (2017). Effectiveness of Intradialytic Stretching Exercises on Prevention and Reduction of Muscle Cramps among Patients undergoing Haemodialysis at PSG Hospitals Coimbatore. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602044753
Lopes, L. C. C., Mota, J. F., Prestes, J., Schincaglia, R. M., Silva, D. M., Queiroz, N. P., … Peixoto, M. do R. G. (2019). Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial. Archives of Physical Medicine and Rehabilitation, 100(11), 2151–2158. https://doi.org/10.1016/j.apmr.2019.06.006
Manfredini, F., Mallamaci, F., Arrigo, G. D., Baggetta, R., Bolignano, D., Torino, C., … Elhafeez, S. A. (2017). Exercise in Patients on Dialysis : A Multicenter , Randomized Clinical Trial. 1259–1268. https://doi.org/10.1681/ASN.2016030378
Martins do Valle, F., Valle Pinheiro, B., Almeida Barros, A. A., Ferreira Mendonça, W., de Oliveira, A. C., de Oliveira Werneck, G., … Moura Reboredo, M. (2019). Effects of intradialytic resistance training on physical activity in daily life, muscle strength, physical capacity and quality of life in hemodialysis patients: a randomized clinical trial. Disability and Rehabilitation, 0(0), 1–7. https://doi.org/10.1080/09638288.2019.1606857
Mohammad Abd Elbaky, M., Mohammed Zaki, S., Mohammed Amin, N., & Mohammed Nagib Ali, R. (2018). Impact of Intradialytic Rehabilitation Program on General Health of Chronic Kidney Disease Patients. American Journal of Nursing Research, 6(5), 263–272. https://doi.org/10.12691/ajnr-6-5-7
Parker, K. (2016). Intradialytic Exercise is Medicine for Hemodialysis Patients. Current Sports Medicine Reports, 15(4), 269–275. https://doi.org/10.1249/JSR.0000000000000280
Po, J., & Parimala, S. (2020). Assess the Effect of Intradialytic Stretching Exercises to Reduce Leg Muscle Cramps among Patients Undergoing Hemodialysis in Selected Dialysis Unit of Ernakulum District. 6(2), 1–6.
Poornazari, M., Dehghani, K., Shahbazi, S., & Khaledi Sardashti, F. (2017). Impact of a designed isotonic exercise program on pain intensity of muscle cramps in legs of patients undergoing hemodialysis; a randomized clinical trial. Journal of Nephropharmacology, 6(2), 85–89. https://doi.org/10.15171/npj.2017.10
Poornazari, M., Roshanzadeh, M., Parsa, S., & Tajabadi, A. (2019). Effect of Isotonic Exercise on the Frequency of Muscle Cramps in Hemodialysis Patients : A Clinical Trial. 8(1), 1–5. https://doi.org/10.5812/msnj.85770.Research
Salem, S. S., & Elhadary, S. M. (2017). Effectiveness of Intra-dialytic Stretching Exercises on Leg Muscle Cramp among Hemodialysis Patients. IOSR Journal of Nursing and Health Science, 06(02), 47–53. https://doi.org/10.9790/1959-0602094753
Wilkinson, T. J., Watson, E. L., Gould, D. W., Xenophontos, S., Clarke, A. L., Vogt, B. P., … Smith, A. C. (2019). Twelve weeks of supervised exercise improves self-reported symptom burden and fatigue in chronic kidney disease: A secondary analysis of the “ExTra CKD” trial. Clinical Kidney Journal, 12(1), 113–121. https://doi.org/10.1093/ckj/sfy071
Zelko, A., Skoumalova, I., Kolarcik, P., Rosenberger, J., Rabajdova, M., Marekova, M., … Reijneveld, S. A. (2019). The effects of intradialytic resistance training on muscle strength, psychological well-being, clinical outcomes and circulatory micro-ribonucleic acid profiles in haemodialysis patients: Protocol for a quasi-experimental study. Medicine, 98(19), e15570. https://doi.org/10.1097/MD.0000000000015570
Xie, Z., Liu, K., Or, C., Chen, J., Yan, M., & Wang, H. (2020). An examination of the socio-demographic correlates of patient adherence to self- management behaviors and the mediating roles of health attitudes and self-efficacy among patients with coexisting type 2 diabetes and hypertension. 1–14
Yin, X. (2005). Understanding the factors influencing diabetes self-management in chinese people with type 2 diabetes using structural equation modeling. (Order No. 3196957, University of Cincinnati). ProQuest Dissertations and Theses, , 162-162 p. Retrieved from http://search.proquest.com/docview/305004492?accountid=17242