Nurse-led exercise in haemodialysis sarcopenia showed trends, not proof

Design

Cluster randomised trial by dialysis schedule

Population

56 haemodialysis patients with possible or confirmed sarcopenia

Primary outcome

Muscle mass index, grip strength, gait speed and SPPB at 12 weeks

Effect

Favourable trends in strength and function, not significant after Bonferroni correction

This cluster-randomised trial allocated 56 haemodialysis patients with possible or confirmed sarcopenia, grouped by dialysis shift, to a 12-week nurse-led multicomponent exercise programme or standard care. Fifty completed it.

The exercise group showed favourable trends in grip strength, gait speed and physical performance scores, with moderate-to-large effect sizes, but none remained significant after correction for multiple comparisons. Muscle mass, quality of life and CRP did not differ. No serious adverse events occurred.

The trial shows that intradialytic or shift-based exercise led by nurses is safe and feasible. It is too small to show benefit.

• Screen haemodialysis patients for sarcopenia with grip strength and gait speed.
• Encourage supervised exercise for dialysis patients as safe and feasible.
• Treat functional gains from exercise programmes as likely but not yet proven in this population.

Why it matters

Dialysis time is an underused opportunity to address frailty.

Don't overread it

No outcome reached significance after correction; this is feasibility evidence.

The statistics, in plain English

Bonferroni correction makes the threshold for significance stricter when many outcomes are tested. Effects that looked meaningful lost significance after correction, which in a 56-patient trial most likely reflects limited power.

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