This narrative review explores the types and benefits of intradialytic exercise (IDE) for patients undergoing hemodialysis (HD). IDE, which includes physical activities performed during HD sessions, aims to improve patients' strength, endurance, and overall health. The review highlights various forms of IDE, such as intradialytic aerobic exercise (IAE), intradialytic resistance exercise (IRE), stretching exercises, blood flow restriction exercise (BFRE), intradialytic inspiratory muscle training (IIMT), and intradialytic neuromuscular electrical stimulation (INES). IAE is noted for its accessibility and effectiveness in enhancing physical functions, reducing fatigue, and improving health-related quality of life (HRQoL). IRE is particularly beneficial for increasing muscle strength and mass. Stretching exercises help mitigate muscle cramps and restless legs syndrome.

Although BFRE and combined exercise programs show promise, further research is necessary to consolidate their benefits. The review also addresses the safety, feasibility, and adherence of IDE, noting that IDE is safer and has higher adherence rates compared to exercises performed outside HD clinics, due to supervision by medical staff and regular scheduling. However, IDE faces challenges such as limited space, equipment, scheduling conflicts, and patient motivation. Despite these barriers, IDE is a potential intervention for improving the health outcomes of HD patients, advocating for its integration into routine HD care to optimize patient prognoses and enhance the standard of care.