Intradialytic cognitive and physical exercise for enhancing cognitive function in haemodialysis patients: a systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background Cognitive impairment negatively impacts patients on maintenance haemodialysis. This review evaluates the effects of combined cognitive and physical training on cognitive outcomes in this population. Methods This review protocol was registered with PROSPERO (CRD420251076992). Cochrane Library, PubMed and LIVIVO databases were searched for randomised controlled trials and quasi-experimental studies evaluating the combined interventions among adult patients on haemodialysis for ≥ 3 months. Studies done on patients with prior malignancy or infections, acute kidney injury, active psychosis or delirium, severe arthritis or any other physical disability contraindicating exercise, undergoing peritoneal dialysis, or having had a kidney transplant were excluded. Meta-analyses using random effects models compared the intervention with standard care. The Cochrane Risk of Bias 2 tool assessed potential bias. Results Five records (three randomised controlled trials and two additional records) with 195 patients were included. Two studies consistently showed a significant improvement in Trail Making Test B with intervention compared with control (mean difference 21.11 s; 95% confidence interval 11.93, 30.29; p < 0.01). Two additional studies evaluating the difference between Trail Making Test B and Trail Making Test A favoured the intervention (mean difference = 10.82; 95% confidence interval 1.1, 20.53; p = 0.03). Another meta-analysis of two studies showed an improvement in Montreal Cognitive Assessment scores with the intervention (mean difference 1.98; 95% confidence interval 0.43, 3.53; p = 0.01). Conclusions Integrated intradialytic cognitive and physical therapy appears to improve cognitive function in patients with end-stage kidney disease.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.018 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.016 | 0.022 |
| Bibliometrics | 0.005 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".