Evaluation of a pragmatic exercise rehabilitation programme in chronic kidney disease

Greenwood, Sharlene; Lindup, Herolin; Taylor, Kevin; Koufaki, Pelagia; Rush, Robert; Macdougall, Iain C.; Mercer, Thomas H.

doi:10.1093/ndt/gfs272

Cited by 103 publications

(129 citation statements)

References 27 publications

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“…Consistent with previous research, despite the staff's perspective that exercise was beneficial for patients (17,35), there was a lack of readiness for IDE (17,36). Our results extend these findings by identifying important considerations in implementation of IDE.…”

Section: Discussionsupporting

confidence: 71%

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Thompson

Klarenbach

Molzahn

2016

CJASN

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Background and objectives Randomized, controlled trials show that regular exercise is beneficial for patients on hemodialysis. Intradialytic exercise may have additional benefits, such as amelioration of treatment-related symptoms. However, the factors that influence the implementation of intradialytic exercise are largely unknown.Design, setting, participants, & measurements Individual semistructured interviews were conducted with a purposive sample of patients on hemodialysis who had participated in a pilot randomized, controlled trial on intradialytic exercise and dialysis staff that worked in the unit during the trial. The trial took place from July to December of 2014 and enrolled 31 patients. Interviews were conducted from April to December of 2014. Interview coding followed an inductive and broad-based approach. Thematic analysis was used to group codes into common themes, first individually and then, across staff and patient interviews.Results Twenty-five patients and 11 staff were interviewed. Three themes common to both groups emerged: support, norms (expected practices) within the dialysis unit, and the role of the dialysis nurse. The support of the kinesiologist enhanced patients' confidence and sense of capability and was a key component of implementation. However, the practice of initiating exercise at the start of the shift was a barrier to staff participation. Staff focused on the technical aspects of their role in intradialytic exercise, whereas patients viewed encouragement and assistance with intradialytic exercise as the staff's role. An additional theme of no time (for staff to participate in intradialytic exercise) was influenced by its low priority in their workflow and the demands of the unit. The staff's emphasis on patients setting up their own equipment and enhanced social interaction among participants were additional themes that conveyed the unintended consequences of the intervention. ConclusionsThe kinesiologist-patient interactions and staff readiness for intradialytic exercise were important factors in the implementation of intradialytic exercise. Understanding how unit workflow and the personal values of staff can influence implementation may improve the design of intradialytic exercise interventions.

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Section: Discussionsupporting

confidence: 71%

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Thompson

Klarenbach

Molzahn

2016

CJASN

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“…In our study, the TUG test was able to detect changes in mobility and balance at 9.3% of kidney transplant patients, similar to the study by Greenwood, Lindup, Taylor, Koufaki, Rush, Macdougall 23 . These authors subjected patients with chronic kidney disease (pre-dialysis, dialysis, and transplantation) to a 12-week rehabilitation program and observed that, for the kidney transplant, the TUG showed a reduction of 25% of their time at the end of the program 23 .…”

Section: Discussionsupporting

confidence: 89%

“…These authors subjected patients with chronic kidney disease (pre-dialysis, dialysis, and transplantation) to a 12-week rehabilitation program and observed that, for the kidney transplant, the TUG showed a reduction of 25% of their time at the end of the program 23 . In our study, we observed that patients with an altered TUG received the graft from deceased donor and the majority was in the group above 11 years of kidney transplantation.…”

Section: Discussionmentioning

confidence: 99%

Functional independence and mobility in kidney transplanted patients: cross-sectional study

Maia

Rocha

Bezerra

et al. 2017

Motriz: rev. educ. fis.

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-Aim -To assess functional independence, balance and mobility of kidney transplant recipients, to verify transplant time, donor type, regular exercise practice, musculoskeletal complaints, as well as association among these variables. Methods: Observational study with 86 kidney transplant individuals, subjected to evaluation of the Functional Independence Measure (FIM) and Timed Up and Go test (TUG). Results: The mean age of the study population was 43.98 years old, 50% of these individuals were between 5-10 years of transplantation and 50% between 10-15 years. Changes in mobility and balance (TUG) were found in 9.3% of transplant patients, while 2.3% had deficits in functional independence (FIM). The association between TUG and the FIM (χ2= 19.964, p< 0.001) was found in 25% of the 9.3% of individuals who showed changes in TUG. It was found that only 20.9% of kidney transplant between 5-10 years and 14.0% between 11 and 15 years performed regular physical exercises (χ2= 0.727, p= 0.394) and 67.4% presented prevalent complaints on lower limbs musculoskeletal. Conclusion: Although the level of dependence and impairments in mobility and balance found in renal transplants are low, deficits in mobility and balance may lead to changes in the ability to perform their functional activities independently.

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“…Studies point out that an exercise program can maintain and, even increase the variables of functional capacity in dialysis patients (7).…”

Section: Introductionmentioning

confidence: 99%

Physical exercise modifies the functional capacity of elderly patients on hemodialysis

et al. 2016

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Evaluation of a pragmatic exercise rehabilitation programme in chronic kidney disease

Cited by 103 publications

References 27 publications

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

A Qualitative Study to Explore Patient and Staff Perceptions of Intradialytic Exercise

Functional independence and mobility in kidney transplanted patients: cross-sectional study

Physical exercise modifies the functional capacity of elderly patients on hemodialysis

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