A STUDY TO ASSESS THE EFFECTIVENESS OF INTRADIALYTIC EXERCISE ON MUSCLE CRAMPS AND QUALITY OF LIFE AMONG PATIENTS UNDERGOING HEMODIALYSIS IN SELECTED HOSPITAL,CHENNAI

1. BY,
MR.VEERESH KADEMANI.
Ist YEAR M.SC NURSING.
SDMU’S IONS. DHARWAD.
TO THE ARTICLE
PRESENTATION

2. • “A Study To Assess The Effectiveness
Of Intradialytic Exercises On Muscle
Cramps And Quality Of Life Among
Patients Undergoing Hemodialysis In
Selected Hospital, Chennai”.
P. SUBITHA [ PRIMARY RESEARCHER ]
DEEPA. M [ RESERCH GUIDE ]

3. • Name of the journal:-
Research & Review :
Management Of Emergency
And Trauma Nursing
• Volume :- 02
• Issue :- 02 [ March - August, 2020 ]

4. Chronic or irreversible renal failure is a progressive
reduction of functioning renal tissue such that the
remaining kidney mass can no longer maintain the
body’s internal environment.
Intradialytic exercises helps to reduce
muscle cramps, improve physical function and quality of
life of patients undergoing hemodialysis. It is simple and
feasible. Hence the study was conducted to assess the
effectiveness of intrdialytic exercises on muscle cramps
and quality of life among patients undergoing
hemodialysis.

5. 1) To assess the muscle cramps and quality of life among patients
undergoing hemodialysis before and after intervention.
2) To assess the effectiveness of intradialytic exercises on muscle
cramps and quality of life among patients undergoing
hemodialysis.
3) To associate the post interventional level of muscle cramps and
quality of life with selected demographic variables and clinical
variables among patients undergoing hemodialysis.
4) To correlate the post interventional level of muscle cramps and
quality of life among patients undergoing hemodialysis.

6. H1: There is a significant difference between pre
and post interventional score of muscle cramps
and quality of life among patients undergoing
hemodialysis.
H2: There is a significant association between
post interventional score of muscle cramps and
quality of life with demographic and clinical
variables of patients undergoing hemodialysis.

7. Research Approach :- Quantitative Research Approach.
Research Design :- Quasi Experimental Two Group
Pre And Post Test Design.
Sample :- Patients undergoing Haemodialysis with
Muscle Cramps.
Sample size :- 80 (experimental group = 40)
(control group= 40)
Sampling Technique :- Non probability Purposive Sampling.
Duration of study :- 2 weeks.

8. The patients who
 were in the age group of 21 to 70 years.
 are alert and cooperative.
 are undergoing Haemodialysis with Muscle Cramps.
 were both male and female.
 could understand Tamil or English.

9.  Demographic Variables
 Clinical Variables
 Intra Dialytic Muscle Cramps Assessment
Tool
 Modified Kidney Disease Quality Of Life
Short Form Scale.

10.  The study was approved by the Institutional Review Boards at
the University and the clinical site.
 The study were conducted among 80 samples undergoing
hemodialysis (Experimental group = 40; Control group = 40) in
selected hospital.
 After obtaining informed consent from samples , using self
report interview schedule the investigator collected the
demographic and clinical data.
 And assessed the pre interventional level of muscle cramps
using Intra Dialytic Muscle Cramps Assessment Tool and quality
of life by Modified Kidney Disease Quality Of Life Short Form
Scale.
 After, for the experimental group, the investigator demonstrated

11. Bilateral straight legged raise
& knee flexion
Neck
stretch
Shoulder shrug
&
rotation
Triceps extension
Elbow flexion
Supine hip flexion
Supine hip abduction
Supine hip adduction
Leg stretch

12. Before the initiation of hemodialysis and reinforced
the patients to continue the same for 30 minutes
during second and fourth hour from the initiation of
hemodialysis procedure.
The intradialytic exercises were continued for a
period of 2 weeks (6 hemodialysis sitting).
On day 12, post interventional level of muscle
cramps and quality of life was assessed by using the
same scale.
The patients in control group received hospital
treatment regimen.

13. Frequency and percentage distribution was
used to analyze the demographic variables and
clinical variables of the samples undergoing
hemodialysis.
Mean and standard deviation was used to
assess
the pre and post interventional level of muscle
DATA MANAGEMENT AND ANALYSIS
Descriptive and inferential statistics were used for data anal

14.  Student independent ‘t’ test and paired ‘t’ test
was used to compare the level of muscle cramps
and quality of life of patients in experimental and
control group.
 Chi square test was used to associate the post
interventional muscle cramps and quality of life
with selected demographic and clinical variables
in experimental and control group.
 Correlation coefficient was used to correlate the
post test level of muscle cramps and quality of
life among patient undergoing hemodialysis

15. DEMOGRAPHICS
1) Age :- majority (37.5%) of the patients in experimental and
control group were in age group of 51- 60 years.
2) Gender :- 75% of the patients in the experimental group &
80% patients in the control group were male.
3) Educational status :- 35% of the patients in experimental and
control group had secondary education.
4) Occupational status :- 62.5% of the patients in experimental
group & 67.5% in control group were employed.

16. DEMOGRAPHICS,
5) Marital status :- 100% of the patients were married in
both experimental and control groups.
6) Income :- in the experimental group, 55% of the patients
and in the control group 57.5% patients monthly income
Rs 10.000 - <15.000.
7) Type of family :- 75% & 70% of the patients in the
experimental and control group were from the nuclear family.
8) Dietary pattern :- 82.5% of the patients in both
experimental control group were non-vegetarian.

17. CLINICAL VARIABLES,
In the experimental group, 47.5% of the patients had
hypertension, 22.5% of the patients had diabetic mellitus
and hypertension as associated illness,
Whereas in the control group, 50% of the patients had
hypertension, 22.5% of the patients had diabetic mellitus
as associated illness.
In the experimental group, 65% of patients were
undergoing hemodialysis for 1- < 3years duration and in
the control group 57.5% of the patients were undergoing
hemodialysis for 1- < 3years duration.

18. CLINICAL VARIABLES,
In the experimental and control group,100% of patients
were undergoing hemodialysis for 4 hours per sitting.
In relation to intake medications , 100% of patients in the
experimental and control group were taking calcium
supplements.
Regarding awareness about exercise during dialysis,
87.5% of the patients in experimental group and 100% of
the patients in control group were unaware of exercises

19.  In relation to current creatinine level, 50% of patients creatinine level
between 8 mg/dl and above, 40% of the patients creatinine level between
5-<8 mg/dl in the experimental group. Where as in the control group, 45%
of patients creatinine level between 5-<8mg/dl, 40% of patients creatinine
level between 8mg/dl and above.
 In the experimental group, 45% of patients were prescribed fluid intake
range between 251-250 ml. 35% of patients were prescribed fluid intake
range between 501-1000 ml. where as in control group, 55% of patients
were prescribed fluid intake range upto 250 ml, 30% of patients were
prescribed fluid intake range between 251-500 ml.
 In relation to occurrence of muscle cramps during non dialysis days, 45%
of patients had muscle cramps in the experimental group and in the
control group 50% of patients had muscle cramps during non dialysis days
particularly at night.
CLINICAL VARIABLES,

20. 1) The first objective was to assess the muscle cramps and
quality of life among patients undergoing hemodialysis before
and after intervention.
In pre test, all patients in the experimental & control group had
severe muscle cramps. In post test, experimental group, majority of
the patients (82.5%) had no muscle cramps, whereas in control
group, majority of the patients (92.5% ) had severe muscle cramps.
In pre test majority of the patients (92.5%) had poor quality of life in
the experimental group, whereas in the control group, all patients
had poor quality of life , in post test, majority of the patients (57.5%)
had moderate quality of life and 70 patients (42.5%) had good
quality of life in the experimental group, whereas in the control
group, majority of the patients (92.5%) had poor quality of life.

21. 2) second objective was to assess the effectiveness of
intradialytic exercises on muscle cramps and quality of life
among patients undergoing hemodialysis.
In the experimental group, pre test mean muscle cramps score
was higher than the post test mean score and pre test quality of
life mean score was lower than the post test score, whereas in the
control group, pre and post test mean score was almost same.
There was a statistically significant difference in pre and post test
mean score at p< 0.001level in experimental group. Hence we
can infer that the intradialytic exercises were effective in
reducing muscle cramps and improving in the quality of life
among patients undergoing hemodialysis.

22. 3) The third objective was to associate the post interventional level of muscle
cramps and quality of life with selected demographic variables and clinical
variables among patients undergoing hemodialysis.
 There was a statistically significant association found between ,
- the post interventional levels of muscle cramps with demographic
variables such as age, educational qualification at 5% level.
- the post interventional levels of muscle cramps with clinical variables
such as duration of undergoing hemodialysis, awareness regarding
exercises during hemodialysis at 5% level.
- the post interventional quality of life of the patients undergoing
hemodialysis with dietary pattern at 5% level.
- post interventional quality of life of the patients undergoing
hemodialysis with clinical variables such as awareness regarding
exercise during hemodialysis at 5% level.

23. 4) The fourth objective was to correlate the
post interventional level of muscle cramps
and quality of life among patients
undergoing hemodialysis.
There was a low negative correlation
between muscle cramps and quality of life
in the experimental and control group
among patients undergoing hemodialysis.

24. The study findings showed
that intradialytic exercise were effective in
reducing muscle cramps and improving the
quality of life among patients undergoing
hemodialysis intradialytic exercises can be
used as A non pharmacological measure in
reducing muscle cramps and improving
quality of life of patients undergoing
hemodialysis

25.  Intradialytic exercises can be incorporated as one of the
routine nursing interventions in reducing muscle cramps
and improving quality of life among patients undergoing
hemodialysis.
 The same study can be conducted among larger samples
to generalize the findings.
 A comparative study can be conducted to assess the
effectiveness of intradialytic resistance exercises and
intradialytic stretching exercises in reducing muscle
cramps and improving quality of life among patients
receiving hemodialysis and peritoneal dialysis.

26. STRENGTHS AND WEAKNESSES
STRENGTHS :- The strength of the study is non
probability purposive sampling technique which
focuses on chronic renal failure patient undergoing
intradialytic exercises which helps to reduce muscle
cramp, improves physical function and quality of life
of the patient.
WEAKNESSES :- The investigators could assess the
effect of intervention only once during the period of
data collection.