Trial reportHealth technology assessment (Winchester, England)2021
Exercise programme to improve quality of life for patients with end-stage kidney disease receiving haemodialysis: the PEDAL RCT.
Trial report in Health technology assessment (Winchester, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 7 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 7 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Pooled it
- Effects of exercise dose based on the ACSM recommendations on depression in hemodialysis patients: a systematic review and meta-analysis of randomized controlled trials.Frontiers in physiology · 2024Pooled it
- The effect of exercise on vascular health in chronic kidney disease: a systematic review and meta-analysis of randomized controlled trials.American journal of physiology. Renal physiology · 2023Pooled it
- Interventions for fatigue in people with kidney failure requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- Interventions to increase physical activity level in patients with whole spectrum chronic kidney disease: a systematic review and meta-analysis.Renal failure · 2023Pooled it
- Pooled it
- Association of Exercise With Vascular Function in Patients With CKD: A Meta-Analysis of Randomized Controlled Trials.Frontiers in medicine · 2022Pooled it
- Effectiveness of a BCW theory-based exercise adherence intervention protocol in Chinese maintenance hemodialysis patients: a randomized controlled trial.Frontiers in public health · 2025Trial
- Blood Flow Restriction Training in Hemodialysis Patients: Clinical Benefits, Challenges, and Future Perspectives.Hemodialysis international. International Symposium on Home Hemodialysis · 2026Review
- Characteristics, Attitudes and Preferences of an End-Stage Kidney Disease Population at the Beginning of an Exercise Program: A Pragmatic Multicenter Trial.Journal of clinical medicine · 2026Article
- Using behavioural theory to explore barriers and facilitators to physical activity in haemodialysis patients: an updated systematic review of qualitative evidence.Health psychology and behavioral medicine · 2026Review
- Resistance-Based Muscle Therapy, Frailty, and Muscle Biopsy Findings in Kidney Transplant Candidates: A Clinical Trial.Kidney medicine · 2025Article
- Nephrologists' Insights on Exercise in Renal Health.Kidney & blood pressure research · 2025Article
- Exploring How the Kidney BEAM Physical Activity Digital Health Intervention Improved Mental Health-Related Quality of Life for People Living With Kidney Disease.Kidney international reports · 2024Article
- Feasibility of randomized controlled trials and long-term implementation of interventions: Insights from a qualitative process evaluation of the PEDAL trial.Frontiers in rehabilitation sciences · 2023Article
- Commentary: A scale development study: hemodialysis comfort scale version II.Journal of research in nursing : JRN · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
22 authors at 16 institutions in 2 countries.
Funding
Abstract
backgroundWhether or not clinically implementable exercise interventions in haemodialysis patients improve quality of life remains unknown.
objectivesThe PEDAL (PrEscription of intraDialytic exercise to improve quAlity of Life in patients with chronic kidney disease) trial evaluated the clinical effectiveness and cost-effectiveness of a 6-month intradialytic exercise programme on quality of life compared with usual care for haemodialysis patients.
designWe conducted a prospective, multicentre randomised controlled trial of haemodialysis patients from five haemodialysis centres in the UK and randomly assigned them (1 : 1) using a web-based system to (1) intradialytic exercise training plus usual-care maintenance haemodialysis or (2) usual-care maintenance haemodialysis.
settingThe setting was five dialysis units across the UK from 2015 to 2019.
participantsThe participants were adult patients with end-stage kidney disease who had been receiving haemodialysis therapy for > 1 year.
interventionsParticipants were randomised to receive usual-care maintenance haemodialysis or usual-care maintenance haemodialysis plus intradialytic exercise training.
main outcome measuresThe primary outcome of the study was change in Kidney Disease Quality of Life Short Form, version 1.3, physical component summary score (from baseline to 6 months). Cost-effectiveness was determined using health economic analysis and the EuroQol-5 Dimensions, five-level version. Additional secondary outcomes included quality of life (Kidney Disease Quality of Life Short Form, version 1.3, generic multi-item and burden of kidney disease scales), functional capacity (sit-to-stand 60 and 10-metre Timed Up and Go tests), physiological measures (peak oxygen uptake and arterial stiffness), habitual physical activity levels (measured by the International Physical Activity Questionnaire and Duke Activity Status Index), fear of falling (measured by the Tinetti Falls Efficacy Scale), anthropometric measures (body mass index and waist circumference), clinical measures (including medication use, resting blood pressure, routine biochemistry, hospitalisations) and harms associated with intervention. A nested qualitative study was conducted.
resultsWe randomised 379 participants; 335 patients completed baseline assessments and 243 patients (intervention, LIMITATIONS: Participants could not be blinded to the intervention; however, outcome assessors were blinded to group allocation.
conclusionsOn trial completion the primary outcome (Kidney Disease Quality of Life Short Form, version 1.3, physical component summary score) was not statistically improved compared with usual care. The findings suggest that implementation of an intradialytic cycling programme is not an effective intervention to enhance health-related quality of life, as delivered to this cohort of deconditioned patients receiving haemodialysis. FUTURE WORK: The benefits of longer interventions, including progressive resistance training, should be confirmed even if extradialytic delivery is required. Future studies also need to evaluate whether or not there are subgroups of patients who may benefit from this type of intervention, and whether or not there is scope to optimise the exercise intervention to improve compliance and clinical effectiveness.
trial registrationCurrent Controlled Trials ISRCTN83508514.
fundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.