Kidney Failure​

An Exercise Plan for All

Keeping an active lifestyle is essential for all age groups to maintain physical function and health.
You are encouraged to:

  • Complete the PAR-Q checklist prior to any physical exercise. Do check with your doctor if you answered “No” to any of the questions.
  • Increase physical activity whenever possible to avoid a sedentary lifestyle.
  • Gradual increase of exercise duration, frequency and intensity is recommended for best adherence and least injury risk.

Physical Activity vs Exercise

What’s the difference?

Physical activity is any bodily movement that requires the use of energy, such as climbing up the stairs, taking a walk at a nearby park or to the market and doing household chores.

Physical exercise, which is a sub-category of physical activity and is referred to planned and structured repetitive movements to achieve fitness goals and improvements.
Exercise and physical activity are two different concepts and often get used interchangeably; it’s important to know the difference, especially when you start to set a goal for yourself. Of course, both exercise and physical activity are important to maintain a healthy lifestyle, so let’s get moving!

How Much Exercise Should I Do?

FITT Table

Use the FITT formula below allows you to create a training programme suited to your own body! It helps you plan and modify your workouts to avoid boredom, injuries from overstrain and weight loss plateaus. Tailor the guidelines to your needs and remember: progressive overloading is key!

Activity Formula Adult Seniors
Cardiovascular Frequency At least 2-4 times a week At least 3 times a week
Intensity Moderate to Vigorous Light – Moderate
Time 150 minutes 150 minutes
Type Long periods of cardiovascular endurance such as jogging, swimming, kickboxing, dancing, cycling, rowing, skiing
Strength & Conditioning Frequency At least 2-3 times a week At least 2-3 times a week
Intensity Moderate - Hard Low - Moderate
Time 5 – 10 exercises per session, targeting multi-joint movements
Each exercise: 12–15 repetitions, for 2~3 sets
Type Body weight, free weight, resistance bands, weighted machines
Flexibility Frequency At least 2-3 times a week
Intensity Light – Moderate (Stretching to slight discomfort is normal)
Time 15 – 30 seconds hold per repetition for each muscle-tendon complex, 2~4 sets
Type Dynamic warm-up favored over static stretches; Static for cool down for range of motion (ROM) maintenance

Intensity of exercise can be determined and tracked using the simple test and indicators below.

Method 1: The Self Talk Test

The talk test is an easy tool to determine your exercise intensity.

You are doing moderate-intensity exercise if you can talk but not sing, whereas more vigorous exercise results in an inability to say more than a few words without pausing for a breath.

Physical Activity/Exercise Level classification Heart Rate Maximum (%) Perception of Effort
Sedentary/no habitual activity or exercise/extremely deconditioned 57 – 67% Light – Moderate
Minimal physical activity/no exercise/moderately-high deconditioned 64 – 74% Light – Moderate
Sporadic physical activity/no or sub-optimal exercise/moderately to mildly deconditioned 74 – 84% Moderate – High
Habitual physical activity/regular moderate to vigorous intensity exercise (*Not to be attempted by patients on dialysis) 80 – 91% Moderate – High
High amounts of habitual activity/regular vigorous intensity exercise (*Not to be attempted by patients on dialysis) 84 – 94% Somewhat hard – Hard

Method 2: Target Heart Rate and Heart Rate Zone

One way to find your maximum heart rate (maxHR) is to subtract your age from 220. E.g. If you are 60 years old, your HRmax – Age would be 220 – 60 = 160 beats per minute.

HRmax = 220 – Age

Target Heart Rate = ((HRmax – resting HR) x % Intensity) + resting HR

*Karvonen Formula

My Training Heart Rate Zone

Appropriate heart rate zones are useful in identifying suitable training intensity for each individual so as to optimise fitness and performance level effectively. Training in accurate zones can also minimise risk of injury.

Please Enter Your Age, Resting Heart Rate and Desired Training Intensity Level

Years Old
Beats Per Minute
(Refer to My Heart Efficiency)  
(Training Intensity)

Know My Heart Efficiency

The pulse rate measurement at rest can determine how the heart is functioning and overall cardiovascular fitness level. Inefficiency occurs when the heart requires more beats to do the same amount of work, over time this can lead to cardiovascular diseases.

Resting Heart Rate = Number of Heart Beats per Minute

*Place your middle and index finger on your radial artery on the wrist or your carotid artery at the neck to locate your pulse.

Please Enter your Number of Heart Beats for 30 Seconds.

  Beats (x2)

Your Resting Heart Rate is     Beats Per Minute

Exercise Training Alert:
This formula incorporates the heart rate reserve to calculate training zones based on both maximum & resting heart rate, making the calculation more customised to individual’s fitness level. This consideration enables a more accurate training zone to be determined as compared to percentage of maximum heart rate (220 – age). Try to exercise according to your personal heart rate zone to maximise cardiovascular health benefits and optimise fitness level!


  • Individuals with medical conditions should consult a registered medical practitioner before attempting to intensify their exercise efforts.
  • These recommendations are consistent with the United States Department of Health & Human Services
    Physical Activity Guidelines for American. Adapted from ACSM’s Guidelines for Exercise Testing and
    Prescription (8th Ed).

Benefits of Exercise

It is never too late to get trim and fit! As you grow older, an active lifestyle becomes more important than ever to your health.

Benefits of exercising include (but not limited to):

Physical benefits:

  • Increase overall physical function
  • Reduce risk of falls
  • Reduce progression/onset of osteoporosis
  • Regulates blood pressure and reduces risk for type 2 diabetes

Mental benefits:

  • Improve cognitive function
  • Improve overall mood by kicking up endorphin levels
  • Decrease stress (Increase production of neurohormones such as norepinephrine)
  • Regulate body’s circadian rhythm (Although improved sleep is a psychological benefit of exercise, sleep experts recommend not exercise close to bedtime)

Myths on exercise and aging

There are many reasons why seniors tend to slow down and become more sedentary as they grow older. It may be due to health problems, weight or pain issues, or worries about falling.

Tips to overcome physical and emotional obstacles to getting active:

  • Reduce exercise intensity to low-moderate to tailor to your needs
  • Increase physical activity whenever possible e.g. daily walks, gardening, household chores
  • Joining clubs or social events can help increase motivation levels to stay active
As you age, you don’t have enough energy to exercise.

Myth: The more active you are, the better your activity tolerance is and the more you can do throughout the day.

Seniors are too old to exercise.

Myth: A randomised control trial analysed the effects of home exercise programs in 200 subjects aged 60 and older. Improvements in balance, lower quarter strength and disability ratings were measured after the program. No adverse health effects were noted with any of the participants.

Reference: Jette, A. M., Lachman, M., Giorgetti, M. M., Assmann, S. F., Harris, B. A., Levenson, C., Krebs, D. (1999). Exercise – it’s never too late: the strong-for-life program. American journal of public health, 89(1), 66–72.

Seniors could easily get injured while exercising.

Myth: If exercise is performed and progressed correctly, there is lower injury risk with physical activity for all ages.

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The National Kidney Foundation (NKF) strives to be an advocate and integrator for kidney health and holistic care for the community by the community. While supporting kidney failure patients with quality dialysis treatment and integrated care, its greater mission lies in preventing or delaying kidney failure through kidney health education with deeper integration into the community and strategic collaborative partnerships.
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