Home-Based Otago Exercise Improves Sleep Quality and Dialysis Adequacy in hemodialysis patients: Study

A new study published in the journal of BMC Nephrology revealed that home-based Otago exercise is a safe, low-cost, and effective intervention for patients undergoing hemodialysis. Regular practice of this program leads to improvements in both sleep quality and dialysis adequacy. Teaching patients how to perform these exercises at home and ensuring regular follow-up is recommended to maximize benefits.

Hemodialysis patients frequently struggle with poor sleep and insufficient dialysis efficiency, both of which can negatively affect overall health and quality of life. This randomized controlled clinical trial was set to evaluate whether structured home exercise could help reduce these problems. The study focused on a practical program that patients could perform independently at home with minimal supervision.

A total of 46 patients receiving hemodialysis at two dialysis centers were recruited and randomly assigned to either an intervention group or a control group. Participants in the intervention group were trained to perform a home-based Otago exercise routine 3-times per week over an 8-week period. The program included balance and strength-building movements and was supported by regular follow-up from healthcare providers to ensure adherence and safety.

This research assessed outcomes using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and two widely used dialysis adequacy indicators, the Kt/V and the Urea Reduction Ratio (URR). Measurements were taken before and after the intervention for both groups. Of the initial participants, 44 completed the study with the demographic characteristics being comparable between the groups.

Sleep quality scores improved significantly in the intervention group, which indicated fewer disturbances and better overall rest. Dialysis efficiency also improved, with statistically significant gains observed in Kt/V values and URR levels after the 8-week intervention period.

The intervention confirmed differences in sleep quality and Kt/V measurements when compared to control groups, demonstrating that the exercise program had measurable clinical benefits. While URR improvements were significant within the intervention group, differences between the two groups were not statistically significant.

This study emphasized that the exercise routine proved to be safe and feasible for patients to perform at home. No serious adverse effects were reported, which suggested that the program can be integrated into routine patient care without major risks or costs.

Overall, the findings of this study highlighted that home-based exercise programs represent a practical and accessible strategy for improving both sleep and dialysis outcomes in hemodialysis patients. Healthcare providers should incorporate structured exercise education into patient care plans and maintain regular follow-up to support long-term adherence.

Source:

Afaghi, E., Beigmohammadi, H., Rajai, N., & Pishgooie, A. H. (2026). Effectiveness of Otago exercise on sleep quality and dialysis adequacy in hemodialysis patients. BMC Nephrology. https://doi.org/10.1186/s12882-026-04835-y