Intradiay dialysis exercise to improve posture in adults with end-stage kidney disease

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This randomized, assessor-blinded trial compares a 12-week, supervised intradialytic multimodal exercise program plus usual care to usual care alone in adults receiving maintenance hemodialysis. The program includes postural correction, resistance, core training, stretching, breathing, and seated cycling three times per week during dialysis sessions. Primary outcome is change in thoracic kyphosis angle from baseline to Week 12, with secondary outcomes like craniovertebral angle, balance, mobility, functional capacity, gait speed, activity level, adherence, and adverse events. The study aims to generate preliminary evidence on feasibility, safety, and potential clinical value of integrating posture-focused exercise into dialysis care.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age 18-80 years
* Diagnosed with ESRD and receiving stable maintenance hemodialysis for at least 3 months at the participating center, with a dialysis frequency of three sessions per week
* Confirmed presence of at least one postural abnormality (hyperkyphosis ≥53° in women or ≥55° in men, or CVA \<53°) assessed at screening
* Written informed consent obtained, indicating decision-making capacity and willingness to participate
* Medical clearance from attending nephrologist to participate in supervised exercise during dialysis
* Ability to sit upright in a dialysis chair and perform seated or supported standing exercises
* Ability to communicate in Persian and understand study instructions

Exclusion Criteria:

* Unstable cardiovascular status, including recent (within 3 months) myocardial infarction, unstable angina, decompensated congestive heart failure (NYHA Class III-IV), or uncontrolled arrhythmia
* Active infection, acute febrile illness, or acute medical condition requiring hospitalization
* Hemodynamic instability defined as systolic blood pressure \<90 mmHg or \>200 mmHg, or severe orthostatic hypotension, at screening or prior to exercise sessions
* Uncontrolled diabetes mellitus with labile glycemic control (blood glucose \<4 mmol/L or \>22 mmol/L at dialysis session start)
* Severe musculoskeletal pain at rest or with minimal activity (Numeric Pain Rating Scale ≥7/10) that would preclude exercise participation
* Inability to perform seated exercises, walk independently, or maintain upright posture; severe neurological disability
* Recent fracture (within 6 months) of vertebral column, pelvis, or lower extremities
* Severe peripheral neuropathy or vascular disease (ABI \<0.6) precluding lower limb exercise
* Dyspnea at rest or with activities of daily living corresponding to NYHA Class IV
* Participation in a structured exercise program targeting postural correction, resistance, or balance training ≥3 times per week in the preceding 3 months
* Severe cognitive impairment (MMSE \<18) preventing informed consent or adherence to exercise instruction
* Pregnancy or planned pregnancy during the study period
* Life expectancy \<6 months as determined by the attending nephrologist
* Scheduled kidney transplantation within the study period

Where it's running

• Pardis specialized wellness institute
  Isfahan, Iran Recruiting

Study contacts

• Principal investigator: Mohammad Ali Tabibi, Dr — Pardis Specialized Wellness Institute
• Study coordinator: Nasrin Salimian
• Email: statisrin@gmail.com
• Phone: +98913251202

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.