Background：The patients with end-stage renal disease receiving hemodialysis therapy experienced lower muscular strength, decreased metabolic function, and poorer quality of life compared to the general population. The factors were associated with more muscular wasting, increased cardiovascular risks, and fatigue. These eventually leaded to elevated mortality rate.

Purpose：The purpose of this study was to explore the barriers that blocked the exercise participation in hemodialysis patients.

Methods：Searching the following key words " hemodialysis’’, ’’exercise or physical activity’’, and ‘’barriers’’ in the databases of Cochrane Library, PubMed and CINAHL, which restricted with the duration of five years. Total nineteen articles were found with the exclusion criteria: peritoneal dialysis patients, intervention study, development scale, and review articles. Finally, six articles were selected. I choose most appropriate three articles of these studies.

Results：Two of these articles showed that older patients on hemodialysis encountered more barriers to exercise. All the three studies revealed that the factor ‘‘having too many medical problems” was the most commonly reported barrier in patients on chronic hemodialysis. At the multivariate analysis, the first study pointed out that reduced walking ability, fatigue on the non-dialysis days, and shortness of breath were independently and negatively associated to low physical activity.

Conclusions：The most barrier to exercise in the patients on hemodialysis was ‘‘having too many medical problems’’. The barriers independently associated with physical inactivity. In the future, more studies need to define the barriers to physical inactivity in the other hemodialysis populations. To define the barriers to exercise in the patients on hemodialysis will provide new therapeutic strategies to improve the physical activity, and then we can design a suitable exercise program for these patients.