Ask yourself, if you could take a pill to increase your energy level, muscle mass, bone strength and decrease cardiovascular risk, would you? Exercise on dialysis could be that pill. The purpose of an exercise program is to provide a holistic approach to care, enabling patients to shift their focus from sick to well, to be the best they can be. The benefits of exercise include improved quality of life, and an interruption of the downward spiral of deconditioning which leads to inactivity and disability (Painter, 1995) These benefits have been well documented by Patricia Painter, PhD, and the London Health Sciences Centre, London, Ontario (Ridley, Hoey, Ballagh-Howes, 1999). In 1999, our vision of an in-centre hemodialysis exercise program became a reality. Now, one year after implementation, keeping patients motivated and staff committed to participate in this effective program has become our latest goal.