TOPLINE:

The use of an intradialytic virtual reality (VR) platform that combined exercise, nutritional education, cognitive training, and psychological support over 4-12 weeks was feasible and safe, preserved gait speed, and increased muscle strength in the lower limbs in patients undergoing haemodialysis. 

METHODOLOGY:

• Researchers conducted a clinical trial to assess the feasibility and safety of the Good for healthy lifestyle and RENal for renal health (GoodRENal) intradialytic platform, a VR‑based holistic, interdisciplinary, non-pharmacologic programme, to increase physical activity in patients undergoing haemodialysis at two centres (one each in Spain and Greece).
• A total of 41 patients (mean age, 64.5 years; 29.3% women) undergoing haemodialysis were randomly assigned to either the GoodRENal intervention group (n = 20) or the usual care control group (n = 21).
• The GoodRENal platform was delivered on a laptop and incorporated non-immersive VR scenarios (serious games) designed to promote physical activity, nutritional education, psychological well-being, and cognitive function; patients moved their legs while concurrently performing nutrition-related, cognitive, or psychological tasks. A depth camera was used to track lower limb movements during dialysis.
• The primary outcome was feasibility of the GoodRENal platform (expressed as recruitment, retention, and adherence rates). Safety outcomes included the occurrence of adverse events during intervention sessions.
• Physical performance was evaluated using gait speed, the sit-to-stand test, handgrip strength, and the 6-minute walk test. Muscle strength in the lower limbs was measured using handheld dynamometry. Assessments were conducted at baseline, after 4 weeks, and after 12 weeks (in Spain only).

TAKEAWAY:

• The overall recruitment rate was 53.2% (83.3% in Greece and 39.6% in Spain).
• Retention and adherence rates ranged from 91% to 100% and from 60.9% to 100%, respectively, across centres. The most common reason for missed sessions was a lack of motivation. No adverse events, including fatigue, cramps, or hypotension, were reported in the intervention group.
• After 4 weeks, gait speed was preserved in the intervention group; however, a small decline was noted in the control group (P = .049).
• After 12 weeks, the intervention group showed significant improvements in muscle strength in the lower limbs compared with the control group (change in left hip flexors: 29.3 N vs -4 N; P < .001, and change in right hip abductors: 27.4 N vs -2.5 N; P < .001).

IN PRACTICE:

"The GoodRENal platform is a feasible and safe intervention to promote intradialytic exercise and results in increased lower-limb muscle strength. This finding can potentially benefit patients on HD [haemodialysis] in dialysis centres that do not have physiotherapists available," the authors wrote.

SOURCE:

This study was led by Eva Segura-Ortí, PhD, Universidad Cardenal Herrera-CEU, CEU-Universities, Valencia, Spain. It was published online on April 22, 2026, in Kidney Medicine.

LIMITATIONS:

The study had a small sample size drawn from only two dialysis centres. The duration of the intervention differed between centres, with one centre implementing the programme for 4 weeks and the other for 12 weeks. Additionally, the VR games used on the platform were not developed by an expert video game company. 

DISCLOSURES:

This study received support from the Ministerio de Ciencia, Innovación y Universidades; Agencia Estatal de Investigación; and the European Union. One author declared employment with Baxter Healthcare. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.