A combined progressive muscle relaxation and walking intervention for adults with end-stage kidney disease receiving hemodialysis (Fight Fatigue): Study development and protocol

Fatigue has a profound negative impact on health for adults with end-stage kidney disease (ESKD) who receive maintenance hemodialysis. There are currently no standard-of-care therapies to alleviate this fatigue. Progressive muscle relaxation and physical activity have decreased fatigue in other populations. In collaboration with a patient partnership board, we developed an intervention aimed at reducing fatigue for adults receiving maintenance hemodialysis ( Fight Fatigue ), and we describe the protocol for its feasibility trial. Fight Fatigue was informed by our formative work with a patient partnership board (n=3). Three virtual meetings were held, followed by 1:1 interviews with each board member. During the meetings, qualitative data was collected about the board’s experience with fatigue and their feedback on the components of the intervention, which focused specifically on progressive muscle relaxation and increasing steps per day, as well as the study procedures. The Fight Fatigue intervention was developed informed by these findings. In the planned feasibility trial of this intervention, participants will be enrolled and randomized to either the Fight Fatigue intervention or an attention control. Data will be collected at baseline, week 6, and week 12. For this trial, the primary study endpoints are feasibility and acceptability, with a secondary endpoint of fatigue. The findings of this feasibility trial will inform the development of a randomized controlled trial of a combined mind-body and physical activity intervention to address fatigue for adults with ESKD receiving hemodialysis. NCT07014111 • Fatigue is a prevalent and distressing symptom for those with end-stage kidney disease (ESKD). • The Fight Fatigue intervention was informed by work done with a patient partnership board. • Fight Fatigue will be evaluated in a 12-week trial investigating feasibility and acceptability.