Physical exercise in haemodialysis patients: which type of exercise is more convenient?

Randomized intra-haemodialysis and home-based exercise trials have demonstrated similar efficacy in improving physical performance, particularly in increasing walking distance. During dialysis sessions, patients can engage in structured, supervised activities such as cycling or resistance exercises, ensuring safety and immediate feedback from healthcare professionals. This structured nature can significantly enhance adherence, making exercise a regular part of the patient's treatment schedule. Home-based exercise offers flexibility and convenience. Patients can incorporate activities like walking, stretching or using resistance bands into their daily lives. This flexibility allows patients to exercise at their own pace and according to their preferences, fostering independence and self-management. By continuing physical activity at home, patients can maintain continuity in their exercise regimen, which is crucial for long-term health benefits. Combining both intra-haemodialysis and home-based exercises has the potential to improve overall adherence to exercise programs. Strategies such as patient education, customized plans, monitoring and feedback, and support systems can help combine these two exercise types. By integrating these two modalities, healthcare providers can create a comprehensive and balanced exercise regimen that enhances adherence, promotes independence and maximizes health benefits for dialysis patients, fostering long-term health and well-being through sustained physical activity. However, this dual approach, which caters to both the need for medical supervision and the desire for personal autonomy, has yet to be tested in randomized trials.