Quality of life and physical activity level in patients with chronic kidney disease during COVID-19 pandemic

Effects of early mobilization in elderly patients undergoing cardiac surgery

BACKGROUND

Although early mobilization is associated with improved outcomes in postoperative cardiac patients, implementation of early mobilization in elderly patients is still a challenge.

AIMS

In this study, we aimed to design and assess an early mobilization program for cardiac rehabilitation.

METHODS

We conducted a clinical trial in elderly patients aged over 65 years after coronary artery bypass graft surgery. Patients were randomly assigned to an early mobilization group (Group A) or a routine therapy group (Group B). Short-Form International Physical Activity Questionnaire (SF-IPAQ), to assessment balance Time Up and Go (TUG), to assessment functional capacity the 2-min walking test (2MWT) and the short physical performance battery (SPPB) were used as a reference to formulate and monitor the early mobilization regimen.

RESULTS

A total of 100 patients were enrolled (n = 50 per group). The mean walking distance in Group A was significantly higher at 135.6 ± 9.29 than the mean walking distance in Group B which was lower at 123.4 ± 8.48. Also, the patients in Group B had a mean SF-IPAQ of 389.44 with an SD of 85.7, P < 0.001, whereas the mean SF-IPAQ amount in Group A was 556.16 with an SD of 91.47. In early mobilization group, a strong positive connection was indicated by the correlation coefficient of r = 0.957 between the amount of SF-IPAQ and 2 MWT and there was a significant negative association r =  - 0.768 between 2MWT and TUG.

CONCLUSION

Our study's findings suggest that early mobilization and functional exercises enhanced balance, functionality, and life quality for older cardiac patients.

Home-based tele-exercise training and physical activity during the COVID-19 pandemic in chronic kidney disease patients

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and lockdown reduced physical activity levels in hemodialysis (HD) patients and kidney transplant recipients (KTRs). This study aimed to describe physical activity levels during lockdown and assess the effects of an online home-based exercise training program on physical activity levels in HD patients and KTRs.

METHODS

Forty-five HD patients and thirty-five KTRs were divided into four groups: exercise groups 1 (ΕΧ-HD) and 2 (EX-KTR) followed a 4-month tele-exercise training program, while control groups received usual care. All participants at baseline and at the end of the study completed the International Physical Activity Questionnaire (IPAQ), while their daily physical activity levels were recorded via a step counting application.

RESULTS

At the end of the study, the repeated measures analysis revealed a significant effect of time, group, and time-by-group interaction in the average steps per day, walking, and moderate activity for the exercise-HD group (p < 0.05). Similarly, the analysis revealed a notable effect of time, group, and time-by-group interaction in the exercise-KTR group in average daily steps, vigorous and walking activity (p < 0.05). Multiple regression analysis showed that the level of physical activity at the end of the study was related to the urban place of residence and the participation in the 4-month exercise program of both HD patients and KTRs.

CONCLUSIONS

Participation in a tele-exercise training program led to favorable effects on physical activity levels both in HD patients and KTRs during lockdown.

Upper extremity functions and physical activity in chronic maintenance hemodialysis patients: A case-control study

Continuous hemodialysis (HD) treatment causes many complications in patients. The aim of this study is to evaluate the upper extremity functional capacity, physical activity level, and physical functions of patients receiving continuous HD treatment. Fifty HD patients and fifty healthy subjects were included in the study. Hand grip strength with Dynamometer, range of motion of upper extremity with Digital Goniometer, functional level of the upper extremity with the Turkish version of the Shoulder, Arm, and Hand Problems Questionnaire (The DASH-T), physical activity levels with international physical activity questionnaire short form and physical functions with the human activity profile (HAP) were evaluated. The mean grip strength of the subjects in the control group was 23.3 ± 1.44 kg, while the mean grip strength of the HD patients with fistula was 15.75 ± 3.08 kg (P < .05). In all joint range of motion measurements; the values of HD patients were significantly lower than the control group (P < .05). The DASH symptom scores of the individuals in the HD group (mean 19.19 ± 1.41) were significantly higher than the control group (mean 5.75 ± 1.41) (P < .05). The number of individuals with low-level activity in the HD group (72%) was higher than the control group (34%) (P < .01). The maximum activity score score of the HAP (mean 68.7 ± 1.4) and the adjusted activity score of the HAP (mean 42.54 ± 3.02) were lower in the HD group (P < .0001). HD treatment adversely affects hand grip strength, the range of motion, upper extremity functions, physical activity, and physical function levels of the patients.

Impact of COVID-19 Pandemic on Health-Related Quality of Life and Physical Activity of Patients in Hemodialysis

Chronic dialysis patients have an increased risk of severe COVID-19 infection-related complications. The aim of this study was to quantify the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and physical activity levels of patients undertaking hemodialysis (HD). This was an observational study that compared data from two periods of time, before the COVID-19 pandemic vs pandemic. We used the Medical Outcomes Survey Short Form (SF-36) to measure the HRQoL and the Human Activity Profile (HAP) questionnaire was used to measure the physical activity. Data were analyzed with a mixed ordinal linear regression. A total of 27 eligible participants were interviewed during COVID-19 pandemic (median age 78 years). The linear regression model showed that the pandemic, after controlling for the covariates age, comorbidity, albumin, and hemoglobin, had a significant impact on the HRQoL. Physical function (-15.7) and social functioning subscales (-28.0) worsened (p = 0.001), and the physical component scale also showed a significant decrease (-3.6; p = 0.05). Time had a significant impact on the Human Activity Profile, with an average activity score diminished with the pandemic (-13.9; p = 0.003). The COVID-19 pandemic had a very negative impact on HRQoL and physical activity level of subjects undertaking hemodialysis. Interventions to improve HRQoL and activity levels of patients undertaking HD are recommended.