Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Internal Medicine

Background : Chronic kidney disease (CKD) is a major health problem worldwide with increasing incidence and prevalence. Exercise is often recommended for patients with chronic kidney diseases to improve physical conditioning and reduce complications of diseases. Objective: The purpose of this study was to evaluate the effect of incentive spirometer training on diaphragmatic excursion and quality of life (QoL) in hemodialysis (HD) patients. Subjects and methods: sixty HD patients (30 men and 30 women) participated in the study, their ages ranged from 45-55 years. They were assigned randomly into two groups; 30 patients each: Group (A) received incentive spirometer training with hemodialysis for 8 weeks, 3 sessions per week. Group (B) maintained on hemodialysis only for 8 weeks 3 sessions per week. The study was carried out in the duration from July 2017 to January 2018. Pre and post assessment of diaphragmatic excursion by ultrasonography, 6 min walk test and QoL by SF-36 questionnaire were performed for all patients in both groups. Results: incentive spirometer training induced a significant improvement in diaphragmatic excursion, 6 min walk test result and quality of life score in study group with percent of increase of 24.62%, 12.52%, 55.67% respectively while there were deterioration in control group with percent of decrease of 26.49%, 6.13%, 38.68% respectively. Conclusions: incentive spirometer training for 8 weeks in HD patients results in an improvement of diaphragmatic excursion, the distance walked during 6 min walk test and the QoL score

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