# Effectiveness of Physiotherapy in Haemodialysis: Systematic Review

## TL;DR

This paper reviews how physiotherapy can help patients on hemodialysis by improving their strength, endurance, and quality of life.

## Contribution

The study systematically evaluates physiotherapy's effectiveness in hemodialysis patients across different treatment phases.

## Key findings

- Physiotherapy improves muscle strength and aerobic capacity in hemodialysis patients.
- Exercise reduces fatigue and depression in patients undergoing hemodialysis.
- Therapeutic exercise is beneficial before, during, and after hemodialysis sessions.

## Abstract

Background: Chronic kidney disease (CKD) is a progressive pathology that affects millions of people worldwide, becoming a public health challenge due to its high prevalence and mortality. In its advanced stages, patients require therapies such as haemodialysis (HD), which often entails physical complications, so incorporating physiotherapy as an essential part of the treatment of these patients becomes evident. Objective: To analyse the effectiveness of physiotherapy in patients undergoing haemodialysis before, during and after the treatment. Methodology: This study is a systematic review conducted following the PRISMA statements. An electronic literature search was performed in the following databases: PubMed, PEDro, Chorane Library, ScienceDirect and Dialnet. The inclusion criteria were: controlled and uncontrolled clinical trials published in the last 10 years in English or Spanish, in patients with chronic kidney disease on haemodialysis treatment, aged 18 years or older. Results: 22 studies were included in this review. A total of 1786 patients participated in the included studies. Most of the investigations used cycloergometers, treadmills and bicycles. The programmes varied in types of exercise, with combinations of aerobic, endurance and inspiratory muscle training, with assessments at baseline and at the end of the intervention, some with additional measurements at 8, 12 or 16 weeks, and others with no specified follow-up time. Conclusions: The analysed literature showed that therapeutic exercise can be beneficial for haemodialysis patients, improving muscle strength, aerobic capacity and quality of life. Its implementation, both before, during and after haemodialysis sessions, also helped to reduce fatigue and depression. These results support the importance of exercise in the comprehensive treatment of patients with chronic kidney disease in haemodialysis.