Effect of Two Intradialytic Exercise Programs on Sarcopenia in Hemodialysis Patients

Abstract
Objective: To determine the effects of a non-immersive virtual reality (NIVR) program versus a conventional physical exercise (CPE) program on sarcopenia status in hemodialysis (HD) patients.
Materials and Methods: A quasi-experimental study was conducted with 24 ambulatory HD patients from Consorci Sanitari de Terrassa, Spain. Participants were allocated using convenience sampling to NIVR or CPE groups, with pre-post measurements for handgrip strength (HGS), knee extension strength (KES), Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUG), quality of life (QoL), bioelectrical impedance analysis, and rectus femoris ultrasonography.
Results: The CPE group demonstrated significant changes (P < 0.05) in SPPB (1.89 ± 3.42 points), HGS (1.76 ± 8.65 kilograms), KES (3.98 ± 5.67 kilograms), TUG (-6.092 ± 10.95 seconds), rectus femoris thickness (3.46 ± 1.92 millimeters), pennation angle (0.82 ± 3.16 degrees), and the mobility domain (EuroQol) (-0.4 ± 0.78 points). The NIVR group showed improvements in rectus femoris thickness (3.58 ± 4.54 millimeters) and SPPB static balance (0.55 ± 0.94 points). Sarcopenia status improved in both groups, with more pronounced changes in the CPE group (P > 0.05).
Conclusion: NIVR did not produce effects equal to or superior to CPE in any of the analyzed variables. The practice of any intradialytic exercise program confers benefits for HD patients; however, emerging modalities such as NIVR have yet to surpass CPE.
Keywords: Hemodialysis, intradialytic exercise, non-immersive virtual reality, functional physical capacity, sarcopenia.