Soliman 2015.

Study characteristics
Methods	Study design Parallel RCT Study dates Duration of follow‐up: 8 weeks Time frame: June 2014 to November 2014
Participants	Study characteristics Setting: single centre Country: Egypt Inclusion criteria: male and female; > 18 years; minimum HD vintage of 3 months, stable on HD; no recent hospitalisation; no acute or chronic medical conditions that would make exercise training potentially hazardous or primary outcomes impossible to assess; receiving HD 3 times/week, for 3 or 4 hours/session, having no problems in arteriovenous fistulas, adequate dialysis therapy (Kt/V > 1.2); high‐flux dialysis membrane was in use only those patients who used bicarbonate solution were included; unintentional low dietary protein intake < 1 g/kg of ideal weight/day for at least 2 months, unintentional low dietary energy intake < 30 kcal/kg of ideal weight/day for at least 2 months Exclusion criteria: uncontrolled hypertension; congestive heart failure; arrhythmia requiring treatment; unstable angina; major valvular heart disease; MI, significant arteriosclerosis; risk of fracture; musculoskeletal disorders; change in the resting ECG; severe aortic stenosis; suspected or known dissecting aneurysm; myocarditis; participation in another trial; inadequate dialysis Kt/V < 1.2; Hb < 10 g/dL unstable on dialysis Baseline characteristics Number (analysed/randomised): intervention group (18/23); control group (12/17) Age (years): not reported Sex (M/F): intervention group (8/10); control group (6/6) Dialysis type: HD Dialysis vintage (years) (mean ± SD): not reported Comorbidities CVD: not reported Diabetes: not reported Hypertension: not reported Depression (clinician diagnosis): not reported
Interventions	Intervention classification Non‐pharmacological intervention Indication: study targeting fatigue Intervention group Range of motion exercise Control group No intervention Co‐interventions Not reported
Outcomes	Outcomes reported Fatigue outcome measures used: validation data available Fatigue IFS (Appendix 3): baseline, 1 and 2 months Serum electrolyte level, including phosphate and potassium, and calcium: baseline, 1 and 2 months Hb: baseline, 1 and 2 months BP: baseline, 1 and 2 months Other laboratory parameters (urea, creatinine): baseline, 1 and 2 months
Notes	Additional information Funding: not reported Conflicts of interest/disclosures: none Trial registration identification number: not reported A priori published protocol was not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Sequence generation methods were not reported in sufficient detail to permit judgement. No imbalance between intervention groups was apparent
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment was not reported in sufficient detail to permit judgement. No imbalance between intervention groups was apparent
Blinding of participants and personnel (performance bias) All outcomes	High risk	Not reported. However, interventions were different and investigators/participants could be aware of the treatment assigned
Blinding of outcome assessment (detection bias) All outcomes	High risk	Fatigue was assessed with an appropriate measure, without differences between groups. However, subjective measures were used, it was not stated whether outcomes were assessed without knowledge of treatment allocation, and knowledge of treatment assignment may have influenced reporting. Participant beliefs about the superiority/inferiority of either intervention could have influenced their assessment of the outcome, but there was no evidence that this was likely. However, objective and subjective outcomes were assessed
Incomplete outcome data (attrition bias) All outcomes	High risk	Quote: "40 met the inclusion criteria and agreed to participate within the proposed study, 10 patients were excluded from the study due to death, transplantation or refusing to try to do exercise regularly due to fatigue. Of those, 30 patients completed the study, 18 in experimental group and twelve in control group." Comment: 18/23 participants in the intervention group and 12/17 participants in the control group completed the study (> 5% lost to follow‐up). There were differences between groups. Reasons for discontinuation were provided
Selective reporting (reporting bias)	High risk	Information about the protocol and the statistical analysis plan were not reported. Fatigue was reported using multiple eligible outcome measurements (scales, time points). Fatigue was reported in a format that was extractable for meta‐analysis. All outcomes that should be addressed (fatigue, cardiovascular disease, and death) were not reported
Other bias	Unclear risk	There was no evidence of different baseline characteristics, or different non‐randomised co‐interventions between groups. Funding was not reported