Effect of core stability exercise training on activities of daily living, fatigue level and balance in haemodialysis patients: A randomised controlled study

Background: Hemodialysis (HD) is the most common kidney replacement therapy for end-stage chronic kidney disease. Elderly HD patients, particularly, often struggle with low physical activity, leading to poor physical function, which makes exercise therapy a significant challenge. Objectives: This study aims to evaluate the effects of a combined intradialytic core stability and breathing exercise program on activities of daily living (ADLs), fatigue, balance, and cognitive function in patients on maintenance HD. Method: Sixty patients on maintenance HD were randomly assigned into two equal groups. All patients underwent an intradialytic exercise program. The study group received breathing exercises followed by core stability exercises for 30–45[Formula: see text]min, three times per week for 12 weeks, while the control group underwent only breathing exercises. Results: Baseline characteristics were comparable between groups ([Formula: see text]). Post 12-week intervention, [Formula: see text] mixed ANOVA revealed significant time and interaction effects across all outcomes. The study group showed greater post-intervention improvements than the control in functional independence (Δ [Formula: see text] vs. [Formula: see text]7.4; [Formula: see text]), fatigue (Δ [Formula: see text] vs. −6.4; [Formula: see text]), balance (Δ [Formula: see text] vs. −4.2[Formula: see text]s; [Formula: see text]), and cognition (Δ [Formula: see text]6.0 vs. [Formula: see text]2.4; [Formula: see text]) (all [Formula: see text]), demonstrating superior benefits of the combined exercise program. Conclusion: Integrating core stability with breathing exercises produces significantly greater improvements in ADLs, fatigue, balance, and cognition than breathing alone in haemodialysis patients. This superior, multifaceted approach should be adopted into routine clinical practice to optimise patient quality of life.