• Ryota Matsuzawa, Keika Hoshi, Kei Yoneki, and Atsuhiko Matsunaga.
• Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
• BMJ Open. 2016 May 26; 6 (5): e010990.

IntroductionAs the average age of haemodialysis patients rapidly increases around the world, the number of frail, elderly patients has increased. Frailty is well known to be an indicator of disability and a poor prognosis for haemodialysis patients. Exercise interventions have been safely and successfully implemented for middle-aged or younger patients undergoing haemodialysis. However, the benefits of exercise interventions on elderly patients undergoing haemodialysis remain controversial. The main objective of this study is to systematically review the effects of exercise training on the physical function, exercise capacity and quality of life of elderly patients undergoing haemodialysis, and to provide an update on the relevant evidence.Methods And AnalysesPublished randomised controlled trials (RCTs) that assessed the effectiveness of exercise training on haemodialysis patients with respect to physical function, exercise tolerance and quality of life will be included. Bibliographic databases include MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, CINAHL, Web of Science, PsycINFO and PEDro. The risk of bias of the included RCTs will be assessed using the Cochrane Collaboration's tool and TESTEX. The primary outcome will be physical function and exercise tolerance. This review protocol is reported according to the PRISMA-P 2015 checklist. Statistical analysis will be performed using review manager software (RevMan V.5.3, Cochrane Collaboration, Oxford, England).Ethics And DisseminationEthical approval is not required because this study does not include confidential personal data nor does it perform interventions on patients. This review is expected to inform readers on the effectiveness of exercise training in elderly patients undergoing haemodialysis. Findings will be presented at conferences and submitted to a peer-reviewed journal for publication.Prospero Registration NumberCRD42015020701.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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