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Abstract: TH-PO771

Exercise Games to Improve Balance and Mobility in Diabetic Patients Undergoing Hemodialysis: A Randomized Controlled Trial

Session Information

  • Bioengineering
    October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Bioengineering

  • 300 Bioengineering


  • Al-Ali, Fadwa S., Hamad Medical Corporation, Doha, Qatar
  • Zhou, He, Baylor College of Medicine, HOUSTON, Texas, United States
  • Hamad, Abdullah, Hamad Medical Corporation, Doha, Qatar
  • Ibrahim, Rania Abdelaziz, Hamad Medical Corporation, Doha, Qatar
  • Talal, Talal, hamad medical corp, Doha, Qatar
  • Najafi, Bijan, Baylor College of Medicine, HOUSTON, Texas, United States

Poor balance and mobility are serious problems for older adults undergoing hemodialysis (HD). Patients visit HD clinics multiple times a week which provides an optimal opportunity for intervention. We have developed an interactive foot and ankle exercise game (exergame) that can be played during HD to improve mobility and balance.


Sixty diabetic subjects receiving HD were recruited and randomized into an intervention group (IG: n=29, age=63.3±8years, BMI=31.2±6kg/m2, female=41%) or control group (CG: n=31, age=66.5±10years, BMI=32.3±8kg/m2, female=55%). Both groups underwent a 4-week ankle and foot exercise program (30-min per session, 2 sessions per week) during HD. The IG received exercise via the exergame program (Fig. 1). The CG received foot and ankle exercise without any technology. Balance and mobility were examined at baseline and conclusion of the program.


All IG subjects achieved to complete all exercise tasks. No adverse event were reported. None of the subjects in the IG was dropped out. In balance exam under eyes-open condition, the IG had higher improvement in ankle stability, hip stability, and center of mass sway in response to exercise, when compared with the CG (58% vs. 3%, 47% vs -1%, and 59% vs. -8%, respectively, p<0.05). Similar between-group difference was also observed under eyes-closed condition. From mobility standpoint, results suggested 5% reduction in sedentary behavior (p=0.049, Cohen’s effect size d=0.70) and 53% more vigorous activities in the IG compared to the CG in response to exercise.


This study demonstrated feasibility and effectiveness of an innovative game-therapy program to improve balance and mobility in HD patients. The key innovation of this intervention is its practicality to be done during HD, which could address the limitations of prior exercise interventions in HD patients.


  • Government Support - Non-U.S.