An improved physical condition with these exercises helps improve mobility in certain daily activities, increasing the quality of life of people with chronic kidney disease.
The Association to Fight Against Kidney Diseases of Castellón province (Spain), ALCER Castalia, and the CEU Cardenal Herrera University (CEU UCH) have collaborated to create a Basic Manual of Physical Activity for Chronic Kidney Disease (CKD).
The exercise table with their recommendations, included in this manual, have been designed by Eva Segura, lecturer of the Degree in Physical Therapy at the CEU UCH, who is a pioneer in the implementation in Spain of physical exercise during sessions of hemodialysis. She also currently heads the GoodRenal project, funded by the Erasmus+ European programme, coordinating Spanish entities such as Manises hospital, the University of Valencia and the Polytechnic University of Valencia, and international ones such as the University Hospital of Skånee and the Karolinska Institute of Sweden, the Catholic University of Leuven in Belgium, and the Aristotle University of Thessaloniki of Greece.
Among people who undergo hemodialysis treatment, the feeling of fatigue appears in up to 97% of cases, deeply affecting vitality and personal relationships. Add to this the gradual loss of muscle mass and a sensation of pain that is between two and three times higher than the average.
Furthermore, depression and anxiety are prevalent among between 22 and 42% of people with chronic kidney disease. Suitable physical exercise, with the authorization of the specialist who tends to the patient, can improve these situations, favoring mobility and quality of life while decreasing the sensation of pain.”
Juan Doménech, President, ALCER Castalia
Thus, the Basic Manual of Physical Exercise in CKD, edited by ALCER Castalia, goes over the benefits provided by exercise, not only from a physical point of view, but also its positive effects on the emotional and psychological state, as well as the decrease in blood pressure or glucose levels. The exercises it contains have been specifically designed for people with chronic kidney disease, but they can also be useful for anyone who is in poor shape and want to start doing some physical exercise.
Exercise table and videos
The table of this manual includes exercises such as extending the knees while sitting and flexing the knees while standing, both to strengthen the hamstrings; smooth squats, for the quads; extension and abduction of the hip to strengthen the glutes; standing on tip toes, to work on the calf; or balancing exercise, among others, to improve general muscle mass and mobility. A minute of fast walking is added after each exercise as well as three minutes of regular walking at the beginning and end of the table.
According to Eva Segura, “it is advisable to carry out this exercise table at least three times a week, in 45-minute sessions. The manual also includes a link to the videos we edited, which are available on the YouTube channel of the CEU UCH, and which make it possible to perform the table from home, with recommendations on the appropriate posture and pace. It also includes a diary to write down the exercises performed in each session, the repetitions completed and the perceived effort. Sharing this data with the health professional who tends to the patient will make it possible to increase the intensity of the exercises as the patient’s physical condition improves.”
On Eva Segura Ortí, lecturer at the CEU UCH
Lecturer from the Degree in Physical Therapy of the CEU UCH, Eva Segura, implemented the first exercise programme during hemodialysis in Spain in 2005, at the Hospital General of Valencia. Since then, she has guided its implementation in other Valencian centers, such as the Clínica Virgen del Consuelo or the Doctor Peset hospital.
For four years she has been collaborating with the Nephrology department of Manises hospital, where she also encouraged the use of virtual reality to favor physical exercise among kidney patients on hemodialysis. In this field, Eva Segura heads the GoodRenal project within European programme Erasmus+, with €336,327 in funding. ALCER Castalia collaborated as an associated entity in the European project, providing support with the dissemination and the viewpoint of the patient, so that the results of the project respond to the needs of this group of people. Other associated countries are Chile, Brazil and the United Kingdom.
Furthermore, she also coordinated the REVID intradialytic virtual reality exercise project, with funding from the Spanish R&D and innovation plan.
On ALCER Castalia
ALCER Castalia is a non-profit provincial association declared of Public Utility, which has been striving to improve the quality of life of people with kidney disease and their relatives since 1981, to improve their adaptation to the disease and the treatments, prevent and make chronic kidney disease more visible and to raise awareness in society on the importance of organ donation. They currently tend to over 900 kidney patients in Castellón and Valencia provinces, in the 13 centers where they provide their services, as well as for their relatives.
Since its creation, it is a member of the ALCER National Association Federation, with which it conducts several activities. As well as providing services, it works on disseminating information on the disease and to raise awareness in society, as well as advocating for the rights of affected people. Regarding awareness in society, it is worth noting that ALCER Castalia heads and is currently in charge of, due to its seniority, organization and accrued experience, the organ donation campaigns in Castellón province, which has led to a greater number of organ donor cards, which increases year after year.
Depression linked to chronic pain: Variability shown across patient characteristics