Effect of Intradialysis Virtual Reality Exercise in Hemodinamic Stability: Randomized Trial

Abstract Background: Intradialysis exercise is recommended during the first two hours of the session to avoid hemodynamic instability, but this recommendation is a barrier for the implementation of exercise during dialysis. The main aim of this study was to evaluate the impact of intradialysis exercise in the last two hours versus the first two hours of the HD session on hemodynamic variables. Methods This is a randomized trial. Participants were randomized into two groups. Group A exercised within the first two hours of HD and Group B exercised within the last two hours of HD. The exercise consisted of playing a non-immersive virtual reality video game. The hemodynamic control variables (Systolic blood pressure SBP, diastolic blood pressure DBP and heart rate HR), the number of hypotension events, hypertensive crisis, and cardiac arrhythmias were recorded during the HD sessions. Other variables such as dialysis dose and molecule rebound were also recorded. A mixed linear regression model was used to analyze the results. Results 40 patients completed the study. The SBP, DBP, and HR were compared between groups in different moments (Rest vs Exercise time) and no significant differences were shown. During the intervention period, Group A presented 16 hypotensive events, 10 hypertensive events and 1 arrhythmia event in 725 exercise sessions, while Group B presented 20 hypotensive events, 5 hypertensive events and 1 arrhythmia in 713 exercise sessions. There were no significant differences between groups. Antihypertensive drugs prescribed decreased significantly after the exercise program with similar control of SBP and HR. Conclusion The results showed that an intradialytic VR exercise during the last two hours of the HD session did not result in hemodynamic instability.