***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective Long-term studies regarding the effect of a structured physical exercise programme ( SPEP )  during haemodialysis ( HD ) assessing compliance and clinical benefit are scarce . Study design A single-centre clinical trial , non-r and omised , investigating 46 patients with HD ( 63.2±16.3 years , male/female 24/22 , dialysis vintage 4.4 years ) performing an SPEP over 5 years . The SPEP ( twice/week for 60 min during haemodialysis ) consisted of a combined resistance ( 8 muscle groups ) and endurance ( supine bicycle ergometry ) training . Exercise intensity was continuously adjusted to improvements of performance testing . Changes in endurance and resistance capacity , physical functioning and quality of life ( QoL ) were analysed over 1 year in addition to long-term adherence and economics of the programme over 5 years . Average power per training session , maximal strength tests ( maximal exercise repetitions/min ) , three performance-based tests for physical function , SF36 for QoL were assessed in the beginning and every 6 months thereafter . Results 78 % of the patients completed the programme after 1 year and 43 % after 5 years . Participants were divided — according to adherence to the programme — into three groups : ( 1 ) high adherence group ( HA , > 80 % of 104 training sessions within 12 months ) , ( 2 ) moderate adherence ( MA , 60–80 % ) , and 3 . Low adherence group ( LA , < 60 % ) ) with HA and MA evaluated quantitatively . One-year follow-up data revealed significant ( p<0.05 ) improvement for both groups in all measured parameters : exercise capacity ( HA : 55 % , MA : 45 % ) , strength ( HA : > 120 % , MA : 40–50 % ) , QoL in three scores of SF36 subscales and physical function in the three tests taken between 11 % and 31 % . Moreover , a quantitative correlation analysis revealed a close association ( r=0.8 ) between large improvement of endurance capacity and weak physical condition ( HA ) . Conclusions The exercise programme described improves physical function significantly and can be integrated into a HD routine with a high long-term adherence BACKGROUND AND OBJECTIVES CKD is associated with poor  cardiorespiratory fitness ( CRF ) . This predefined sub study determined the effect of exercise training and lifestyle intervention on CRF and explored the effect on cardiovascular risk factors and cardiac and vascular function . DESIGN , SETTING , PARTICIPANTS , & MEASUREMENTS Between February 2008 and March 2010 , 90 patients with stage 3 - 4 CKD were screened with an exercise stress echocardiogram before enrollment . Patients ( n=83 ) were r and omized to st and ard care ( control ) or lifestyle intervention .  The lifestyle intervention included multidisciplinary care ( CKD clinic ) , a lifestyle program , and aerobic and resistance exercise training for 12 months . CRF ( peak Vo2 ) , left ventricular function , arterial stiffness , anthropometric , and biochemical data were collected at baseline and 12 months . RESULTS Ten percent of r and omized patients had sub clinical myocardial ischemia at screening and completed the study without incident . There was no baseline difference among 72 patients who completed follow-up ( 36 in the lifestyle intervention group and 36 in the control group ) . The intervention increased peak Vo2 ( 2.8±0.7 ml/kg per minute versus -0.3±0.9 ml/kg per minute ; P=0.004 ) . There was small weight loss ( -1.8±4.2 kg versus 0.7±3.7 kg ; P=0.02 ) but no change in BP or lipids . Diastolic function improved ( increased e ' of 0.75±1.16 cm/s versus -0.47±1.0 cm/s ; P=0.001 ) but systolic function was well preserved and did not change . The change in arterial elastance was attenuated ( 0.11±0.76 mmHg/ml versus 0.76±0.96 mmHg/ml ; P=0.01 ) . Δ peak Vo2 was associated with group allocation and improved body composition . CONCLUSIONS Exercise training and lifestyle intervention in patients with CKD  produces improvements in CRF , body composition , and diastolic function Chronic kidney disease ( CKD ) patients have an exaggerated increase in blood pressure ( BP ) during rhythmic h and grip exercise ( RHG 20 % ) and static h and grip exercise ( SHG 30 % ) . Nitric oxide levels increase during exercise and help prevent excessive hypertension by both increasing vasodilation and reducing sympathetic nerve activity ( SNA ) . Therefore , we hypothesized that tetrahydrobiopterin ( BH4 ) , an essential cofactor for nitric oxide synthase , would ameliorate the exaggerated exercise pressor response in CKD patients . In a r and omized , double-blinded , placebo-controlled trial , we tested the effects of 12 wk of sapropterin dihydrochloride ( 6R-BH4 ; n = 18 ) versus placebo  ( n = 14 ) treatement on BP and muscle SNA ( MSNA ) responses during RHG 20 % and SHG 30 % in CKD patients . The 6R-BH4-treated group had a significantly lower systolic BP ( + 6 ± 1 vs. + 13 ± 2 mmHg , P = 0.002 ) and mean arterial pressure response ( + 5 ± 1 vs. + 10 ± 2 mmHg , P = 0.020 ) during RHG 20 % and a significantly lower systolic BP response ( + 19 ± 3 vs. + 28 ± 3 mmHg , P = 0.043 ) during SHG 30 % . Under baseline conditions , there was no significant difference in MSNA responses between the groups ; however , when the BP response during exercise was equalized between the groups using nitroprusside , the 6R-BH4-treated group had a significantly lower MSNA response during RHG 20 % ( 6R-BH4 vs. placebo , + 12 ± 1 vs. + 21 ± 2 bursts/min , P = 0.004 ) but not during SHG 30 % . These findings suggest that 6R-BH4 ameliorates the augmented BP response during RHG 20 % and SHG 30 % in CKD patients . A reduction in reflex activation of SNA may contribute to the decreased exercise pressor response during RHG 20 % but not during SHG 30 % in CKD patients Introduction This study assessed the feasibility and efficacy of a novel resistance training device used within an intradialytic progressive resistance training ( PRT ) intervention Previous studies have suggested the benefits of physical exercise for patients on dialysis . We conducted the Exercise Introduction to Enhance Performance in Dialysis trial , a 6-month r and omized , multicenter trial to test whether a simple , personalized walking exercise program at home , managed by dialysis staff , improves functional status in adult patients on dialysis . The main study outcomes included change in physical performance at 6 months , assessed by the 6-minute walking test and the five times sit-to-st and test , and in quality of life , assessed by the Kidney Disease Quality of Life Short Form ( KDQOL-SF ) question naire . We r and omized 296 patients to normal physical activity ( control ; n=145 ) or walking exercise ( n=151 ) ; 227 patients ( exercise n=104 ; control n=123 ) repeated the 6-month evaluations . The distance covered during the 6-minute walking test improved in the exercise group ( mean distance±SD : baseline , 328±96 m ; 6 months , 367±113 m ) but not in the control group ( baseline , 321±107 m ; 6 months , 324±116 m ; P<0.001 between groups ) . Similarly , the five times sit-to-st and test time improved in the exercise group ( mean time±SD : baseline , 20.5±6.0 seconds ; 6 months , 18.2±5.7 seconds ) but not in the control group ( baseline , 20.9±5.8 seconds ; 6 months , 20.2±6.4 seconds ; P=0.001 between groups ) . The cognitive function score ( P=0.04 ) and quality of social interaction score ( P=0.01 ) in the kidney disease component of the KDQOL-SF improved significantly in the exercise arm compared with the control arm . Hence , a simple , personalized , home-based , low-intensity exercise program managed by dialysis staff may improve physical performance and quality of life in patients on dialysis The aim of this study was to examine the effects of a 12-week home-based exercise program on physical function , psychological dimensions , and health-related quality of life for patients with chronic kidney disease . Ninety eligible patients were enrolled and r and omly separated into the  exercise group and the  control group  from November 2015 to May 2016 . The exercise group received an individualized exercise program while the control group received only usual care and continued primary lifestyle .  Physical function was measured using 6-minute walk test and 10 repetitions of the sit-to-st and test while psychological dimensions were assessed by the Hospital Anxiety and Depression scale and the Self-Efficacy for Exercise scale . Quality of life was evaluated by a disease-specific instrument , the Kidney Disease Quality of Life scale . The differences between the exercise group and the control group were statistically significant for 6-minute walk distance , the time to complete 10 repetitions of the sit-to-st and test , self-efficacy for exercise , anxiety and depression , and all domains of health-related quality of life after a 12-week exercise . This study suggests that home-based individualized exercise program is an effective and feasible way of improving physical function , psychological stress , and health-related quality of life for early stage of chronic kidney disease patients BACKGROUND Sedentary behavior is associated with an increased risk for death in the general population . However , the association between inactivity and mortality has not been studied in a large cohort of dialysis patients despite the high prevalence of sedentary behavior in this group . METHODS We used the Dialysis Morbidity and Mortality Study Wave 2 , a prospect i ve study of a national sample of 4,024 incident peritoneal dialysis and hemodialysis patients from 1996 to 1997 , to determine whether sedentary behavior is associated with increased mortality during a 1-year period in this group after adjusting for confounding variables . RESULTS The study population consisted of the 2,837 patients with accurate survival data who were able to ambulate and transfer . Eleven percent of the sedentary patients died during the study period compared with 5 % of nonsedentary patients . In a survival analysis , sedentary behavior ( hazard ratio , 1.62 ; 95 % confidence interval , 1.16 to 2.27 ) was associated with an increased risk for death at 1 year after adjusting for all variables that we postulated might be associated with survival and for differences between sedentary and nonsedentary patients . CONCLUSION Sedentary behavior is associated with an increased risk for mortality among dialysis patients similar in magnitude to that of other well-established risk factors , such as a one-point reduction in serum albumin concentration . More attention should be given to exercise behavior in dialysis patients , and controlled clinical trials are needed to further define the association of sedentary behavior with mortality PURPOSE To investigate the effect of progressive resistance training ( PRT ) on body composition , physical fitness , quality of life , lipid and nutritional profile of patients on hemodialysis ( HD ) . METHODS A non equivalent comparison group pretest and posttest design study was used with 40 participants who were r and omly assigned to the exercise group ( 20 participants ) and the comparison group ( 20 participants ) . The exercise group received PRT for 30 minutes per session , 3 sessions a week , for 12 weeks , while the comparison group received usual care . The PRT consisted of upper and lower body exercises using elastic b and s and s and bags . Outcome measures evaluated were : body composition , physical fitness , quality of life , and lipid profile . RESULTS Skeletal muscle mass , grip , leg muscle strength , and quality of life all improved significantly in the exercise group . Body fat rate , total cholesterol and triglyceride rate decreased significantly in the exercise group . CONCLUSION These results suggest that PRT improves body composition , physical fitness , quality of life , and lipid profile of patients on HD .  PRT using elastic b and s and s and bags can be utilized as part of a regular care plan for these patients Background : Patients on haemodialysis ( HD ) have a decreased physical and functional capacity . Several studies have reported the beneficial effects of exercise on the physical , functional and psychological functioning of HD patients . Despite these results , exercise programmes on HD are not commonplace . Objective : To analyse the effect of an intradialysis endurance training programme on muscular strength and functional capacity in our HD patients . Material and Methods : A 6-month single-centre prospect i ve study . HD patients were non-r and omly assigned to an exercise group  ( group E ) or a control group ( group C ) . Exercise training included complete endurance training using balls , weights and elastic b and s in the first 2 h of an HD session ; group C received st and ard HD care . Analysed data : ( 1 ) biochemical parameters ; ( 2 ) biceps and quadriceps muscle tone , maximum quadriceps length strength ( MQLS ) and dominant h and grip ( HG 
    Output:
    
Furthermore , studies have shown the beneficial effects of various exercise programs with respect to outcomes such as low physical activity muscle atrophy , quality of life , cardiovascular outcomes and depression .