SYSTEMATIC REVIEW article
Front. Physiol.
Sec. Exercise Physiology
Volume 16 - 2025 | doi: 10.3389/fphys.2025.1600219
Effects of intradialytic exercise on frailty in maintenance hemodialysis patients: A systematic review and meta-analysis
Provisionally accepted
- 1Deyang People's Hospital, Deyang, China
- 2Aobaoka Hospital, Osakasayama, Japan
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Background: The pooled prevalence of frailty in maintenance hemodialysis patients is increasing, and research on the effects of intradialytic exercise to improve frailty remains limited. Objectives: To analyze the effects of intradialytic exercise on frailty in maintenance hemodialysis patients through randomized clinical trials and quasi-experimental studies. Methods: We performed a comprehensive literature search in PubMed, Embase, Web of Science, and Cochrane Library, and English-language publications were indexed from January 2010 to August 2024. Statistical analyses were performed using Review Manager V.5.3 and STATA 15.0. Statistical heterogeneity among studies was quantified using the Chi-square and I-square tests, and publication bias was evaluated using Egger's test and funnel plots. Results: 31 studies involving 1365 maintenance hemodialysis patients were included. The data from the meta-analysis showed that intradialytic exercise significantly reduced frailty score (MD=-0.98, 95%CI:-1.90 to -0.06, p=0.04) and fatigue (SMD=-0.47, 95%CI:-0.72 to -0.23, p=0.0001). Also, intradialytic exercise significantly increased grip strength (MD=2.42, 95%CI:0.78 to 4.06, p=0.004), 6-minute walking distance (MD=36.65, 95%CI:24.90 to 48.39, p<0.0001), and step counts (SMD=0.32, 95%CI:0.04 to 0.60, p=0.03). However, no significant effects were found in body weight (MD=0.71, 95%CI:-1.28 to 2.69, p=0.48). Conclusion: Intradialytic exercise can significantly improve overall frailty and frailty indicators such as grip strength, 6-minute walking distance, step counts, and fatigue. Thus, intradialytic exercises might be a viable strategy for frailty in maintenance hemodialysis patients.
Keywords: 透析内锻炼, 血液透析, 弱点, 效果, 元分析
Received: 27 Mar 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Zou, Zhang, Yi, Chen and Qing. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Qing, 1581401762@qq.com
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