A major advance in treating the kidney failure of end-stage kidney disease is the ability to undergo dialysis–the treatment that removes waste and excess fluid from the blood–at home rather than at a hospital or other outside facility. However, a downside to this development is that a home-dialysis patient is less likely to be seen by a rehabilitation specialist who can evaluate whether he or she would benefit from physical therapy.

In virtually all cases, patients benefit from such a program because over time, long periods of immobility lead to loss of strength and function. Physical therapy, especially targeted strengthening and balance activities, can significantly limit those side effects, breaking what might otherwise become a cycle of debilitation or deconditioning, whereby the patient does not feel well, becomes inactive, grows weaker and can do even less, leading to more inactivity.

Physical therapy services can be rendered at home or elsewhere; the location depends on one’s individual situation. If a program involving relatively simple equipment such as elastic resistance bands is all that is required, home sessions can be quite convenient. However, because using the wider variety of equipment at an outside physical therapy facility could hasten progress, rehabilitation at a physical therapy facility might be a better option.

Every dialysis patient should exercise to the degree that he or she can (with the physician’s permission), understanding that setting goals can help greatly in making progress. Each session should include a very light warm-up and cool-down, with the bulk of the exercise–walking, riding a stationary bike, rowing–in between. The central conditioning workout can last only a few minutes, at first, but as the weeks pass, it should become easier to add time until the session lasts about a half-hour, with 5- to 10-minute warm-ups and cool-downs.

Whether you are about to undergo or are undergoing dialysis, we can design a program to help you avoid the side effects inherent in the immobility that often accompanies the procedure. This way, you can break the cycle of debilitation and feel more like yourself once again.

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