Comparison of Two Forms of Intradialytic Exercises on Strength, Balance and Quality of life in Elderly Hemodialysis Patients with CKD:A Randomized Clinical Trial

The study will include both male and female elderly individuals aged 65 years and above with a Mini Mental State Examination score of 24 or more and a Berg Balance Scale score between 21 and 56 indicating mild to moderate impairment. Participants will be patients with chronic kidney disease undergoing dialysis for at least three months with a minimum of twenty five sessions. The intervention will be delivered during the first one to two hours of ongoing dialysis and outcome measures will be assessed thirty minutes after dialysis. Group A will perform static cycling and stretching three times per week for eight weeks at an intensity of fifty five to sixty percent of maximum heart rate. The program will include five minutes of warm up ten minutes of cycling and ten minutes of stretching of the tendoachilis and hamstrings focusing on aerobic resistance and flexibility training. Group B will undergo podiatric exercises twice per week for eight weeks at the same intensity. This will consist of five minutes of warm up twenty minutes of ankle mobility and strengthening exercises and five minutes of cool down emphasizing resistance and flexibility. The podiatric exercise program will include ankle circles ankle dorsiflexion and plantar flexion toe spreading toe curling using a towel resistance band exercises for dorsiflexion plantar flexion inversion and eversion and plantar fascia stretches thereby targeting ankle mobility and strengthening during dialysis sessions.