The physical deterioration of dialysis patients—Ignored, ill‐reported, and ill‐treated

Bennett, Paul N.; Capdarest–Arest, Nicole; Parker, Kristen

doi:10.1111/sdi.12610

Cited by 19 publications

(15 citation statements)

References 49 publications

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“…Older age is associated with low level of physical activity and declined exercise capacity in CKD, HD and PD populations (Zuo et al 2013; Cobo et al 2015; Cupisti et al 2017). Given that education regarding exercise is not part of routine practice in dialysis care (Bennett et al 2017), it is likely that people treated with PD, especially those of older age, may lack knowledge regarding appropriate exercise regimens. Furthermore, people receiving PD have higher social isolation than those on HD, which could contribute to less exposure to exercise education.…”

Section: Discussionmentioning

confidence: 99%

The Exercise Perceptions of People Treated with Peritoneal Dialysis

Zeng

Bennett

Hill

et al. 2020

Journal of Renal Care

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SUMMARY Background Individuals receiving peritoneal dialysis (PD) report low levels of physical activity, which increases their risk of morbidity and mortality. Little is known about their perceptions towards barriers and benefits of exercise or physical activity. Aim The aim of this study was to explore the perceptions of exercise among people receiving PD. Study Design Cross‐sectional survey. Participants Thirty‐nine adults (12 female and 27 male) with a mean age of 65 years and a median of 8 months receiving PD from one Australian dialysis service. Measurements The 26‐item Dialysis Patient‐Perceived Exercise Benefits and Barriers Survey was adapted to PD in order to measure self‐reported barriers and benefits of exercise for people being treated with PD. Results The majority of the respondents reported positive perceptions towards exercise with 84.6% of the participants agreeing that exercise prevents muscular wasting; 71.8% agreed that exercise can postpone a decline in body function; and 69.2% agreed that exercise improves general well‐being. In terms of barriers, symptoms including tiredness (69.2%) and body pain (43.6%), worrying about a fall (33.3%) and lack of exercise‐related information (25.6%) were the main perceived barriers to exercise. Only 10% agreed that exercise may affect their PD catheter with 23% agreeing that fluid in their peritoneum was a barrier to exercise. Conclusion People on PD hold positive perceptions towards exercise but face a number of perceived barriers to physical activity. Clinicians can acknowledge these barriers and focus on helping people on PD to overcome their perceived barriers to encourage sustained exercise participation.

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Section: Discussionmentioning

confidence: 99%

The Exercise Perceptions of People Treated with Peritoneal Dialysis

Zeng

Bennett

Hill

et al. 2020

Journal of Renal Care

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“…The culture of exercise and rehabilitation in a dialysis clinic would be further enhanced if exercise in chronic conditions was included in medical, nursing, and exercise professional's university curricula. 41 This can assist clinician's understanding to consistently recommend appropriate physical assessment and individualized strategies to increase exercise. 13 Training from an early stage may help to foster required changes to health care providers' perceived professional role in terms of exercise.…”

Section: Service Provisionmentioning

confidence: 99%

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

Clarke

Jhamb

Bennett

2019

Seminars in Dialysis

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Theory‐driven interventions are required to increase the adoption and implementation of physical activity and exercise programs among patients with ESKD. The Behavior Change Wheel (BCW) represents a synthesis of behavior change theories and can be used to aid the systematic development of theory‐driven interventions designed to change exercise behavior. The goal of this review was to synthesize barriers and facilitators to engagement and implementation of exercise and develop theory‐based recommendations for exercise behavior change interventions in patients with ESKD. We applied the BCW in the current context of exercise for ESKD patients and conducted an analysis of patients’ and health care professionals’ (HCPs) capabilities, opportunities, and motivations to engage or promote exercise, respectively. Our analysis identified a number of salient barriers that could be targeted via intervention to increase levels of physical activity and exercise. Intervention functions identified as most likely to change patient behavior included training, enablement, education, restructuring environment, persuasion, modeling, incentivizing, and coercion. Similarly, intervention functions most likely to change HCPs behavior for exercise promotion included training, modeling, education, environmental restructuring, persuasion, and incentivizing. We also considered potential over‐arching policy changes required to support these interventions. Our findings provide theory‐based recommendations that can help inform future clinical and research decision‐making for implementing exercise interventions in these patients. However, high‐quality research in this area is desperately needed to ensure that interventions not only be theory‐driven, but evidence‐based.

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“… 21 Exercise in PD research studies are also scarce, consisting mainly of smaller studies and heterogeneous outcomes 21 , 22 with no large interventional PD exercise (PDEx) studies reported in the United States. 23 Importantly, data to guide providers in the feasibility, design, and implementation of such programs are lacking. Therefore, the aim of this study was to test the feasibility of a PDEx program that could be pragmatically applied within the current PD delivery system in the United States.…”

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confidence: 99%

An Exercise Program for Peritoneal Dialysis Patients in the United States: A Feasibility Study

et al. 2020

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Background People with end-stage kidney disease receiving peritoneal dialysis (PD) are generally physically inactive and frail. Exercise studies in PD are scarce and currently there are no PD exercise programs in the United States. The primary objective of this study was to test the feasibility of a combined resistance and cardiovascular exercise program for PD patients under the care of a dedicated home dialysis center in the United States. Study Design Parallel randomized controlled feasibility study. Setting & Participants PD patients were recruited from a single center and randomly assigned to the intervention (exercise; n = 18) or control (nonexercise; n = 18) group. Intervention The intervention group received monthly exercise physiologist consultation, exercise prescription (resistance and aerobic exercise program using exercise bands), and 4 exercise support telephone calls over 12 weeks. The control group received standard care. Outcomes The primary outcome was study feasibility as measured by eligibility rates, recruitment rates, retention rates, adherence rates, adverse events, and sustained exercise rates. Secondary outcome measures were changes in physical function (sit-to-stand test, timed-up-and-go test, and pinch-strength tests) and patient-reported outcome measures. Results From a single center with 75 PD patients, 57 (76%) were deemed eligible, resulting in a recruitment rate of 36 (63%) patients. Participants were randomly assigned into 2 groups of 18 (1:1). 10 patients discontinued the study (5 in each arm), resulting in 26 (72%) patients, 13 in each arm, completing the study. 10 of 13 (77%) intervention patients were adherent to the exercise program. A t test analysis of covariance found a difference between the treatment groups for the timed-up-and-go test ( P = 0.04) and appetite ( P = 0.04). No serious adverse events caused by the exercise program were reported. Limitations Single center, no blinded assessors. Conclusions A resistance and cardiovascular exercise program appears feasible and safe for PD patients. We recommend that providers of PD therapy consider including exercise programs coordinated by exercise professionals to reduce the physical deterioration of PD patients. Funding None. Trial Registration NCT03980795 .

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The physical deterioration of dialysis patients—Ignored, ill‐reported, and ill‐treated

Cited by 19 publications

References 49 publications

The Exercise Perceptions of People Treated with Peritoneal Dialysis

The Exercise Perceptions of People Treated with Peritoneal Dialysis

Barriers and facilitators for engagement and implementation of exercise in end‐stage kidney disease: Future theory‐based interventions using the Behavior Change Wheel

An Exercise Program for Peritoneal Dialysis Patients in the United States: A Feasibility Study

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