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Abstract Background Adults undergoing haemodialysis have significantly reduced physical capacity and run a high risk of developing cardiovascular complications. Research has shown that intra-dialytic cycling has many evidence-based health effects, but implementation is rare within renal clinical practice. This may be due to several causes, and this study focuses on the patients’ perspective. This perspective has seldom been taken into account when aiming to assess and improve the implementation of clinical research. The aim of this study was to describe how adults undergoing in-centre haemodialysis treatment experienced an implementation process of intra-dialytic cycling. It aimed to identify potential motivators and barriers to the implementation process from a patient perspective. Methods Maximum-variation purposive sampling was used. Data were collected until saturation, through semistructured interviews, which were analysed using phenomenography. Results The implementation of intra-dialytic cycling was experienced as positive, as it had beneficial effects on physical and psychological well-being. It was easy to perform and did not intrude on patients’ spare time. These factors increased the acceptance of the implementation and supported the maintenance of intra-dialytic cycling as an evidence-based routine within their haemodialysis care. The patients did, however, experience some barriers to accepting the implementation of intra-dialytic cycling. These barriers were sometimes so strong that they outweighed the participants’ knowledge of the advantages of intra-dialytic cycling and the research evidence of its benefits. The barriers sometimes also outweighed the participants’ own wish to cycle. The barriers that we identified concerned not only the patients but also the work situation of the haemodialysis nurses. Conclusions Consideration of the motivators and barriers that we have identified can be used in direct care to improve the implementation of intra-dialytic cycling.

Abstract Objectives To evaluate health-related quality of life (HRQoL) in patients in different stages of chronic kidney disease (CKD) up to initiation of dialysis treatment and to explore possible correlating and influencing factors. Methods Cross-sectional design with 535 patients in CKD stages 2–5 and 55 controls assessed for HRQoL through SF-36 together with biomarkers. Results All HRQoL dimensions deteriorated significantly with CKD stages with the lowest scores in CKD 5. The largest differences between the patient groups were seen in ‘physical functioning’, ‘role physical’, ‘general health’ and in physical summary scores (PCS). The smallest disparities were seen in mental health and pain. Patients in CKD stages 2–3 showed significantly decreased HRQoL compared to matched controls, with differences of large magnitude - effect size (ES) ≥ .80 - in ‘general health’ and PCS. Patients in CDK 4 demonstrated deteriorated scores with a large magnitude in ‘physical function’, ‘general health’ and PCS compared to the patients in CKD 2–3. Patients in CKD 5 demonstrated deteriorated scores with a medium sized magnitude (ES 0.5 – 0.79) in ‘role emotional’ and mental summary scores compared to the patients in CKD 4. Glomerular filtration rate Conclusions Having CKD implies impaired HRQoL, also in earlier stages of the disease. At the time for dialysis initiation HRQoL is substantially deteriorated. Co-existing conditions, such as inflammation and cardiovascular disease seem to be powerful predictors of impaired HRQoL in patients with CKD. Within routine renal care, strategies to improve function and well-being considering the management of co-existing conditions like inflammation and CVD need to be developed.

Objective: Coenzyme Q10 supplementation leads to increased muscle metabolism in patients with post-polio syndrome. The aim of this study was to investigate the effect of resistance training in combination with oral supplementation with coenzyme Q10 in patients with post-polio syndrome regarding muscle strength and endurance as well as functional capacity and health-related quality of life., Design: Parallel randomized, controlled, double-blind pilot study., Patients and Methods: A total of 14 patients (8 women and 6 men) with post-polio syndrome participated in a 12-week muscular resistance training, 3 days/week. The patients were randomized for oral supplementation with coenzyme Q10, 200 mg/day, or placebo. Measurements used were: sit-stand-sit test, timed up & go test, 6-minute walk test, muscle strength measurement by means of dynamic dynamometer and short-form (SF)-36 questionnaire., Results: Muscle strength, muscle endurance and quality of life regarding mental health increased statistically significantly in all 14 patients. There was no significant difference between the coenzyme Q10 and placebo groups regarding muscle strength, muscle endurance and quality of life., Conclusion: There was no effect of coenzyme Q10 supplementation during resistance training on post-polio syndrome symptoms. Thus, supplementation with coenzyme Q10 has no beneficial effect on muscle function in patients with post-polio syndrome.