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**23** 

**The Importance of Exercise Programs in** 

Susanne Heiwe1, Andrej Ekholm2 and Ingela Fehrman-Ekholm3,4

*4Stockholm and Transplantation Centre, Sahlgrenska Academy, Göteborg,* 

*1Dept of Physiotherapy, Karolinska Institutet, Dept of Medicine & Dept of Clinical Sciences,* 

The lifestyle today is new. We sit with our computers, televisions etc. Usually, we do not carry heavy things. We gain weight and loose muscle strength. Through history the life has included moments with physical efforts. The body has not changed. It still needs physical training and efforts. The person who is untrained gets quickly tired. Therefore it is important to make the efforts regularly. The capacity of the heart to transport oxygen increases and the energy increases with physical training. The muscle condition is important. The mitochondria in the muscles cells may increase with 30-40 % after one month of exercise. With more mitochondria more fat is consumed and less carbohydrate is needed. Consequently, less lactic acid is formed and the blood does not change the pH towards

Thus, modern people need exercise. You need not to go to a gym or run every day. It is more about having an active life. Take the cycle or walk to the job or to the shop, take the stairs instead of escalator or elevator. The exercise is a part of the natural common life and the body is a tool which needs to be used. It could be enough with 30 minutes of activity to reach physical efforts the heart rate has to increase, maybe to 120 beats/minute. This could be a dilemma for many patients since they have decreased maximal capacity and interacting medication. The training program has to be individualized but the goal is to improve the capacity. If success the daily normal activities feel easier and the patients get more improved trust and comfort. Physical activities mean also better control and less fear of

Thus exercise and effort are important to all of us which are true for many people with different diseases. For patients with cardiac diseases, hypertension, diabetes mellitus there are often exercise programs but for patients with different stages of chronic kidney disease, CKD, there is no obvious exercise treatment program. However, more and more evidence exists that exercises are important for these patients. The dialysis treatment hours have increased more and more to increase KT/V, the dialysis dose, but this also means less time for activities like exercise, work, family life and spear time. How could we help these

having fall accidents. With a feeling of control there are fewer obstacles.

**1. Introduction** 

acidosis as easily.

patients?

**Haemodialysis Patients** 

*3Dept of Renal Medicine, Karolinska University Hospital,* 

*2Karolinska Institutet* 

*Sweden* 

