Development and application of an exercise snacks intervention program for elderly maintenance hemodialysis patients

doi:10.3761/j.issn.0254-1769.2026.05.001

Abstract

Abstract:

Objective To develop an Exercise Snacks（ES） intervention program for elderly patients undergoing maintenance hemodialysis，aiming to provide a practical approach to improve their physical function. Methods Guided by the Theory of Planned Behavior（TPB），the ES intervention program was designed through literature review，expert consultation，and a pilot study. Using convenience sampling，the final sample included 28 participants in the experimental group and 28 participants in the control group from September 2024 to July 2025 at a tertiary hospital in Xinxiang. The experimental group received the ES intervention in addition to routine nursing care，while the control group received routine care only. Changes within groups and differences between groups in Short Physical Performance Battery（SPPB） scores，Kidney Disease Questionnaire（KDQ） scores，and Chinese Self-efficacy for Exercise Scale（SEE-C） scores were evaluated before and after the 12-week intervention. Exercise completion and any exercise-related adverse events were also recorded. Results Totally 26 participants in each group completed the study. The experimental group had higher scores in physical function，quality of life，and exercise self-efficacy compared with the control group（P<0.05）. Exercise adherence was good，and no exercise-related adverse events were reported. Conclusion The ES intervention program for elderly patients undergoing maintenance hemodialysis is safe，feasible，and effective in enhancing physical function，quality of life，and exercise self-efficacy.

Key words: Maintenance Hemodialysis, Aged, Exercise, Physical Function, Nursing Care

摘要：

目的构建老年维持性血液透析患者碎片化运动干预方案并进行初步应用，为改善老年维持性血液透析患者躯体功能提供参考。方法基于计划行为理论，通过文献回顾、专家论证及预试验，构建了老年维持性血液透析患者碎片化运动干预方案。采用便利抽样法，选取2024年9月—2025年7月在新乡市某三级甲等医院接受维持性血液透析的老年患者为研究对象，试验组与对照组各纳入28例。试验组在常规护理基础上实施碎片化运动干预方案，对照组实施常规护理。干预12周后，比较两组干预前后简易躯体功能评估量表、透析患者生活质量量表及运动自我效能量表得分的差异，并记录运动完成情况及相关不良事件。结果最终试验组和对照组各26例完成研究。试验组的躯体功能、生活质量及运动自我效能评分均高于对照组，差异具有统计学意义（P<0.05）。试验组碎片化运动的依从性良好，未出现运动相关不良事件。结论构建的老年维持性血液透析患者碎片化运动方案安全、可行，有效改善了患者的躯体功能、生活质量及运动自我效能。

关键词: 维持性血液透析, 老年人, 运动, 躯体功能, 护理

YANG Jiaqi, WANG Yitong, LI Jie, WANG Lina. Development and application of an exercise snacks intervention program for elderly maintenance hemodialysis patients[J]. Chinese Journal of Nursing, 2026, 61(5): 581-589.

杨嘉琪, 王怡童, 李洁, 王丽娜. 老年维持性血液透析患者碎片化运动干预方案的构建及初步应用[J]. 中华护理杂志, 2026, 61(5): 581-589.

Figures/Tables 6

Table 1 Exercise snacks intervention program for older maintenance hemodialysis patients

Table 2 Exercise standards for the exercise snacks intervention

Table 3 Comparison of general data in the 2 groups

Table 4 Comparison of SPPB scores and various dimensions scores between the 2 groups before and after intervention[scores，M（P25，P75）]

Table 5 Comparison of KDQ scores and various dimensions scores between the 2 groups before and after intervention[scores，$\bar{x} \pm s$]

Table 6 Comparison of SEE-C between the 2 groups before and after intervention（scores，$\bar{x} \pm s$）

References 27

[1]	Wang GN, Dong J, Zhu N, et al. Development and validation of a social alienation predictive model for older maintenance hemodialysis patients based on latent profile analysis:a cross-sectional study[J]. BMC Geriatr, 2024, 24(1):495. DOI
[2]	Li JJ, Xiao WY, Wang LJ, et al. The prevalence of frailty among older adults with maintenance hemodialysis:a systematic[J]. BMC Nephrol, 2025, 26(1):10. DOI
[3]	Yang YJ, Zeng Y, Lü WM, et al. Prevalence and severity of sarcopenia in patients on maintenance hemodialysis:a cross-sectional study[J]. BMC Nephrol, 2024, 25(1):385. DOI
[4]	范晓波, 姜艳萍, 刘慧, 等. 山东省血液透析室护士对患者透析中运动的知信行现状调查[J]. 中华护理杂志, 2024, 59(24):2973-2979. DOI
	Fan XB, Jiang YP, Liu H, et al. Survey on the current status of knowledge,attitude and practice on intradialytic exercise among nurses in hemodialysis rooms of Shandong Province[J]. Chin J Nurs, 2024, 59(24):2973-2979.
[5]	罗细菊, 邓思妍, 陈静, 等. 9种运动方式对提高血液透析患者透析充分性效果的网状Meta分析[J]. 中华护理杂志, 2022, 57(23):2921-2929. DOI
	Luo XJ, Deng SY, Chen J, et al. The effect of 9 types of exercise in improving the dialysis adequacy on patients undergoing hemodialysis:a network Meta-analysis[J]. Chin J Nurs, 2022, 57(23):2921-2929.
[6]	Ghafourifard M, Mehrizade B, Hassankhani H, et al. Hemodialysis patients perceived exercise benefits and barriers:the association with health-related quality of life[J]. BMC Nephrol, 2021, 22(1):94. DOI PMID
[7]	Jones MD, Clifford BK, Stamatakis E, et al. Response to comment on “exercise snacks and other forms of intermittent physical activity for improving health in adults and older adults:a scoping review of epidemiological,experimental and qualitative studies”[J]. Sports Med, 2024, 54(8):2205-2207. DOI
[8]	Western MJ, Welsh T, Keen K, et al. Exercise snacking to improve physical function in pre-frail older adult memory clinic patients:a 28-day pilot study[J]. BMC Geriatr, 2023, 23(1):471. DOI PMID
[9]	Rakhshani T, Bushehri SA, Daneshmandi H, et al. Application of the theory of planned behavior in self-care behaviors of knee osteoarthritis in the rural older people[J]. BMC Geriatr, 2025, 25(1):932. DOI
[10]	Bennett PN, Bohm C, Harasemiw O, et al. Physical activity and exercise in peritoneal dialysis:International Society for Peritoneal Dialysis and the Global Renal Exercise Network practice recommendations[J]. Perit Dial Int, 2022, 42(1):8-24. DOI URL
[11]	邓建华, 田鑫, 杨丹, 等. 维持性血液透析患者运动管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(21):2596-2603.
	Deng JH, Tian X, Yang D, et al. Evidence-based practice of exercise management in maintenance hemodialysis patients[J]. Chin J Nurs, 2022, 57(21):2596-2603.
[12]	Tarazona-Santabalbina FJ, Gómez-Cabrera MC, Pérez-Ros P, et al. A multicomponent exercise intervention that reverses frailty and improves cognition,emotion,and social networking in the community-dwelling frail elderly:a randomized clinical trial[J]. J Am Med Dir Assoc, 2016, 17(5):426-433. DOI PMID
[13]	Welch SA, Ward RE, Beauchamp MK, et al. The Short Physical Performance Battery(SPPB):a quick and useful tool for fall risk stratification among older primary care patients[J]. J Am Med Dir Assoc, 2021, 22(8):1646-1651. DOI URL
[14]	Laupacis A, Muirhead N, Keown P, et al. A disease-specific questionnaire for assessing quality of life in patients on hemodialysis[J]. Nephron, 1992, 60(3):302-306. DOI PMID
[15]	黄小妹, 张英, 张黎民, 等. 武汉地区维持性血液透析患者生活质量及影响因素[J]. 中华肾脏病杂志, 2005, 21(2):88-89.
	Huang XM, Zhang Y, Zhang LM, et al. Quality of life and influencing factors in maintenance hemodialysis patients in Wuhan area[J]. Chin J Nephrol, 2005, 21(2):88-89.
[16]	Resnick B, Jenkins LS. Testing the reliability and validity of the Self-Efficacy for Exercise Scale[J]. Nurs Res, 2000, 49(3):154-159. DOI PMID
[17]	Lee LL, Perng SJ, Ho CC, et al. A preliminary reliability and validity study of the Chinese version of the Self-Efficacy for Exercise Scale for older adults[J]. Int J Nurs Stud, 2009, 46(2):230-238. DOI URL
[18]	Jansons P, Dalla Via J, Daly RM, et al. Delivery of home-based exercise interventions in older adults facilitated by Amazon alexa:a 12-week feasibility trial[J]. J Nutr Health Aging, 2022, 26(1):96-102. DOI PMID
[19]	付琴, 张秀敏, 侯铭, 等. 智能化体感运动在老年慢性阻塞性肺疾病患者居家肺康复中的效果评价[J]. 中华护理杂志, 2025, 60(5):517-524. DOI
	Fu Q, Zhang XM, Hou M, et al. Effect of somatosensory exercise based on artificial intelligence technology in home pulmonary rehabilitation of elderly patients with COPD[J]. Chin J Nurs, 2025, 60(5):517-524. DOI
[20]	Fyfe JJ, Lee Hamilton D, Daly RM. Minimal-dose resistance train-ing for improving muscle mass,strength,and function:a narrative review of current evidence and practical considerations[J]. Sports Med, 2022, 52(3):463-479. DOI
[21]	Wan KW, Dai ZH, Wong PS, et al. Effects of exercise snacks on cardiometabolic health and body composition in adults:a systematic review and meta-analysis[J]. Scand J Med Sci Sports, 2025, 35(8):e70114. DOI URL
[22]	Liang IJ, Perkin OJ, Williams S, et al. The efficacy of 12-week progressive home-based strength and Tai-Chi exercise snacking in older adults:a mixed-method exploratory randomised control trial[J]. J Frailty Aging, 2024, 13(4):572-581. DOI PMID
[23]	Shirai N, Yamamoto S, Osawa Y, et al. Comparison of muscle strength between hemodialysis patients and non-dialysis patients with chronic kidney disease[J]. J Phys Ther Sci, 2021, 33(10):742-747. DOI PMID
[24]	Zhang LY, Zou L, Zhou LJ. Effectiveness of psychoeducational interventions on psychological distress and health-related quality of life among patients with maintenance hemodialysis:a systematic review and meta-analysis[J]. Ren Fail, 2024, 46(1):2331613. DOI URL
[25]	Hargrove N, El Tobgy N, Zhou O, et al. Effect of aerobic exercise on dialysis-related symptoms in individuals undergoing maintenance hemodialysis:a systematic review and meta-analysis of clinical trials[J]. Clin J Am Soc Nephrol, 2021, 16(4):560-574. DOI URL
[26]	Hurst C, Dismore L, Granic A, et al. Attitudes and barriers to resistance exercise training for older adults living with multiple long-term conditions,frailty,and a recent deterioration in health:qualitative findings from the Lifestyle in Later Life-Older People’s Medicine(LiLL-OPM) study[J]. BMC Geriatr, 2023, 23(1):772. DOI
[27]	殷明越, 陈志力, 李汉森, 等. 碎片化运动:兼具应用可行性与健康促进效果的新策略[J]. 西安体育学院学报, 2023, 40(5):615-627.
	Yin MY, Chen ZL, Li HS, et al. Exercise snacks:a novel strategy both with feasibility and health benefits[J]. J Xi’an Phys Educ Univ, 2023, 40(5):615-627.