The effect of low-intensity intradialytic cycling aerobic exercise on cognitive function in patients undergoing continuous hemodialysis

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Abstract
Background. End-stage renal disease (ESRD) patients often experience neurological complications. Mounting evidence suggests cognitive impairment associated with end-stage renal disease is likely related to vascular disruption in the brain, particularly in white matter integrity. Hemodialysis is an independent risk factor for mild cognitive decline (MCD) of ESRD patients and have serious implications for the quality of life. Intradialysis training is the most ideal choice for hemodialysis patients, because not requiring extra time and the patient is also under the supervision of a doctor when doing the exercises. Method. Eighteen patients with end-stage renal disease (ESRD) were randomized into two groups: a treatment group and a control group, with 9 patients in each group. The treatment group participated in low-intensity aerobic exercise on a cycle ergometer, consisting of two 30-minute sessions per week for 12 weeks. Both groups were instructed to continue their regular hemodialysis and medication regimen. MoCA-INA scores were measured before the intervention and again after 12 weeks for both groups. Comparisons of MoCA-INA scores were made within each group as well as between the two groups before and after the 12-week intervention. Results. In the treatment group, the MoCA-INA scores showed a significant improvement from baseline to after the intervention (p < 0.001; effect size = 1.88). In contrast, the control group did not exhibit a significant change in MoCA-INA scores (p = 0.468). Additionally, there was a significant difference in the change in MoCA-INA scores between the treatment and control groups after 12 weeks of intervention (p = 0.001).