The effect of combined Benson relaxation and isometric therapy on fatigue in hemodialysis patients

Abstract

Introduction: Chronic fatigue is a common symptom of chronic kidney disease (CKD), a progressive and life-altering illness that severely reduces a patient's capacity to function normally and their overall quality of life. Although non-pharmacological interventions such as isometric exercises and Benson relaxation therapy have individually shown benefits in reducing fatigue among haemodialysis patients, evidence regarding their combined use remains limited. Further research is therefore needed to determine whether applying these strategies together offers additional benefit in managing fatigue.
Objectives: To examine the effect of combining isometric exercise and Benson Relaxation Therapy on fatigue among haemodialysis patients.
Methods: A quasi-experimental study with two nonrandomized groups (n=19 each) used a pre-test–post-test control design. Stage 5 CKD patients (≥15 years, haemodialysis ≥2/week) were included, excluding those with severe comorbidities, infections, or psychotropic use. The intervention group received a combined protocol of Benson Relaxation Therapy (15–20 minutes) and isometric exercises (15–20 minutes). Fatigue (FSS) was analysed using Wilcoxon signed-rank and Mann–Whitney U tests.
Results: Fatigue in the intervention group decreased from a median (IQR) of 45.0 (19.75) to 39.5 (18.25), Δ = −5.5, while the control group slightly increased from 50.0 (12.0) to 52.5 (11.0), Δ = +2.5. The difference between groups was significant (p < 0.001).
Conclusions: This study demonstrates that combining Benson Relaxation Therapy and Isometric Exercise effectively reduces fatigue in CKD patients undergoing haemodialysis, supporting the integration of holistic, evidence-based, non-pharmacological interventions into nursing practice to enhance physiological adaptation and overall patient well-being.