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Kalderon L, Kaplan A, Wolfovitz A, Levy-Tzedek S, Gimmon Y. Barriers and Facilitators of Vestibular Rehabilitation: Patients and Physiotherapists' Perspectives. J Neurol Phys Ther 2024; 48:140-150. [PMID: 38426842 PMCID: PMC11208053 DOI: 10.1097/npt.0000000000000470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND PURPOSE Poor adherence to vestibular rehabilitation protocols is a known barrier to optimal care. Vestibular clinicians' comprehensive understanding of the barriers and facilitators to vestibular home exercise programs (VHEP) is a key element to achieving optimal care in the context of vestibular rehabilitation. The aims of this study are as follows: (1) to identify primary barriers and facilitators to VHEP from the perspective of patients with vestibular dysfunction and vestibular physical therapists (PTs); and (2) to provide strategies for clinicians to improve adherence and outcomes of VHEP. METHODS A qualitative research with single-session focus groups conducted separately for: (1) patients with vestibular disorders and (2) vestibular PTs. Six focus groups were conducted, 3 for each population, with a total of 39 participants. An online survey was conducted to evaluate the estimates of adherence rates, followed by a structured discussion over barriers and facilitators to VHEP as perceived by patients and PTs. Thematic data analyses were performed using a mixed deductive-inductive approach. RESULTS Eighteen patients with vestibular disorders and 21 experienced vestibular PTs participated in this study. Six barrier categories and 5 facilitator categories were identified. Barriers included motivation aspects, provocation of symptoms, time management, associated impairments, missing guidance and feedback, and psychosocial factors. Facilitators included motivation aspects, time management, patient education and exercise instructions, exercise setting, and associated symptom management. DISCUSSION AND CONCLUSIONS Clinicians who prescribe home exercise to patients with vestibular disorders can use this information about common barriers and facilitators for patient education and to provide optimal care and improve rehabilitation outcomes. VIDEO ABSTRACT AVAILABLE for more insights from the authors (see the video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A467 ).
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Affiliation(s)
- Liran Kalderon
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Azriel Kaplan
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
| | - Amit Wolfovitz
- Recanati School for Community Health Professions, Department of Physical Therapy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel (L.K., A.K., S.L.-T.); Department of Otolaryngology—Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel (A.W., Y.G.); Zelman Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel (S.L.-T.); Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany (S.L.-T.); Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Haifa, Israel (Y.G.)
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Nascimento Alves M, Souza Soares A, Melo Marinho P. Efficacy of resistance exercise during hemodialysis on improving lower limb muscle strength in patients with chronic kidney disease: a meta-analysis of randomized clinical trials. Physiother Theory Pract 2024; 40:1351-1361. [PMID: 36326018 DOI: 10.1080/09593985.2022.2141084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Patients with chronic kidney disease (CKD) on hemodialysis (HD) have muscle weakness in addition to a high risk of falls, motor impairment and immobilization. OBJECTIVE To conduct a systematic review with meta-analysis of randomized clinical trials regarding the effectiveness of resistance exercises on muscle strengthening and lower limb endurance in patients with CKD on HD. METHODOLOGY The study was conducted in the PubMed, EMBASE, SciELO, LILACS and Cochrane databases, without linguistic restrictions or year of publication. RESULTS Of the 824 studies found, only 6 were included for analysis. Studies were allocated to some concern or high risk of bias regarding the reporting of outcomes. The low quality of outcome evidence can mainly be observed due to the severe level of inconsistency owing to the high degree of heterogeneity. A significant reduction in heterogeneity was observed after the sensitivity analysis, demonstrating an improvement in the muscle strength of the lower limbs (p = .002). CONCLUSION It is concluded that most studies demonstrate benefits in carrying out resistance training programs in increasing muscle strength of the lower limbs, however, it is necessary that randomized clinical trials (RCTs) with greater methodological rigor are performed to confirm these findings.
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Li WY, Yeh JC, Cheng CC, Huang SH, Yeh HC, Cheng BW, Lin JW, Yang FJ. Digital health interventions to promote healthy lifestyle in hemodialysis patients: an interventional pilot study. Sci Rep 2024; 14:2849. [PMID: 38310128 PMCID: PMC10838291 DOI: 10.1038/s41598-024-53259-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 01/30/2024] [Indexed: 02/05/2024] Open
Abstract
Low physical activity has been associated with poor prognosis in hemodialysis (HD) patients. Interventions to maintain healthy lifestyle in this population are important to reduce mortality. This study aimed to evaluate the effectiveness of digital health interventions (DHIs) for improving the physical activity and health-related quality of life (HRQoL) in HD patients. The 24-week prospective study enrolled 31 clinically stable HD patients. All participants were assigned home exercises and provided with wearable devices. Dietary and exercise information was uploaded to a health management platform. Suggestions about diet and exercise were provided, and a social media group was created. Physical performance testing was performed at baseline and during weeks 4, 8, 12, 16 and 24. HRQoL and nutritional status were evaluated. A total of 25 participants completed the study. After the interventions, the daily step count increased 1658 steps. The 10-time-repeated sit-to-stand test reduced by 4.4 s, the sit-to-stand transfers in 60 s increased 12 repetitions, the distance of six-minute walk test (6MWT) increased by 55.4 m. The mental health components and burden of kidney disease of the Kidney Disease Quality of Life survey, and subjective global assessment (SGA) scores improved. By Spearman correlation, the monthly step count correlated positively with 6MWT and SGA. DHIs that combined wearable devices, a health management platform, and social media could strengthen physical activity and improve the HRQoL and nutrition of maintenance HD patients. The results outline a new model to promote healthy lifestyle behaviors in HD patients.
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Affiliation(s)
- Wen-Yi Li
- Renal Division, Department of Internal Medicine, National Taiwan University Hospital Yun Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu, Yunlin County, 640, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jiang-Chou Yeh
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliu, Taiwan
| | - Cheng-Chih Cheng
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliu, Taiwan
| | - Su-Hua Huang
- Department of Dietetics, National Taiwan University Hospital Yun Lin Branch, Douliu, Taiwan
| | - Hui-Chin Yeh
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliu, Taiwan
- Department of Applied Foreign Languages, National Yunlin University of Science and Technology, Douliu, Taiwan
| | - Bor-Wen Cheng
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Douliu, Taiwan
| | - Jou-Wei Lin
- College of Medicine, National Taiwan University, Taipei, Taiwan
- Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital Yun Lin Branch, Douliu, Taiwan
| | - Feng-Jung Yang
- Renal Division, Department of Internal Medicine, National Taiwan University Hospital Yun Lin Branch, No. 579, Sec. 2, Yunlin Rd., Douliu, Yunlin County, 640, Taiwan.
- College of Medicine, National Taiwan University, Taipei, Taiwan.
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Chen H, Guan Y, Zhou Z, Shi J, Li L, Shi J, Wang Q, Zou H. Home-based exercise in dialysis patients with end-stage renal disease: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Clin Pract 2024; 54:101822. [PMID: 38048651 DOI: 10.1016/j.ctcp.2023.101822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Lack of exercise may reduce the quality of life, physical capability, and functional capability of dialysis patients. Home-based exercise seems to be a desirable form of low-cost intervention. But the effectiveness of this intervention in the dialysis population is still unclear. The purpose of this meta-analysis is to provide effective evidence to determine the impact of home-based exercise on functional capacity, physical capacity, muscular strength, biochemical parameters, and health-related quality of life among dialysis patients with end-stage renal disease (ESRD). METHODS PubMed, Embase, Cochrane Library, and Web of Science were searched from inception to May 2023, to identify potential randomized controlled trials (RCTs) assessing the effectiveness of home-based exercise in dialysis patients with ESRD. Two independent reviewers selected studies, extracted data, and assessed the risk of bias using the Cochrane tool. Evidence summary using fixed or random effects for meta-analysis. RESULTS Twelve RCTs including 1008 dialysis patients met the inclusion criteria. The meta-analysis showed significant effects of home-based exercise on physical capacity. Seven studies reported the results of the 6-min walking test, compared with short-term (0-3 months) home-based exercise (P = 0.76), long-term (3-6 months) interventions (P < 0.001) can significantly improve the results of the 6-min walking test. The results showed that home-based exercise did significantly improve patients' VO2 peak (P = 0.007). Compared with center-based exercise or usual care, home exercise did not significantly improve handgrip strength, quality of life or CRP and other biochemical parameters (P > 0.05). CONCLUSION The results showed that long-term home-based exercise can improve walking ability. In addition, home-based exercise had the benefit on the VO2 peak of ESRD patients receiving dialysis patients. However, there was no statistically significant difference in handgrip strength, health-related quality of life, CRP, and other biochemical parameters.
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Affiliation(s)
- Hongshuang Chen
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China
| | - Yuxia Guan
- Department of Nephrology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Zijuan Zhou
- Department of Nephrology, Peking Union Medical College Hospital, Beijing, 100730, China
| | - Jiyuan Shi
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China
| | - Lingyu Li
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China
| | - Jiawei Shi
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China
| | - Qinlu Wang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China
| | - Haiou Zou
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100144, China.
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Zhang F, Wang H, Bai Y, Huang L, Zhang H. Handgrip strength and all-cause mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis of cohort studies. Int Urol Nephrol 2023; 55:2857-2865. [PMID: 37076597 DOI: 10.1007/s11255-023-03603-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/13/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVES In observational studies, handgrip strength (HGS), a prognostic marker for healthy aging, has been associated with several chronic disease outcomes. The present systematic review and meta-analysis aimed to determine the quantitative relationship between HGS and the risk of all-cause mortality in patients with chronic kidney disease (CKD). METHODS Search PubMed, Embase, and Web of Science databases. The search was performed from inception to July 20, 2022, and the search was updated in February 2023. Cohort studies were included exploring the relationship between handgrip strength and the risk of all-cause mortality in patients with chronic kidney disease. Effect estimates and 95% confidence intervals (95% CI) were extracted from the studies to perform pooling. The quality of included studies was assessed using the Newcastle-Ottawa scale. We evaluated the overall certainty of evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE). RESULTS This systematic review included 28 articles. A random-effects meta-analysis that included 16,106 patients with CKD showed that participants with lower HGS had an increased mortality risk of 96.1% compared to higher HGS (HR: 1.961; 95% CI 1.591-2.415) (GRADE: very low). Moreover, this association was independent of baseline mean age and follow-up time. In 2,967 patients with CKD, a random-effects model-based meta-analysis showed that for each 1-unit increase in HGS, the risk of death in patients with CKD was reduced by 3.9% (HR: 0.961; 95% CI 0.949-0.974) (GRADE: moderate). CONCLUSIONS In patients with CKD, better HGS is associated with a lower risk of all-cause mortality. This study supports using HGS as a strong predictor of mortality in this population.
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Affiliation(s)
- Fan Zhang
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hui Wang
- Department of Anorectology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan Bai
- Department of Cardiology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Liuyan Huang
- Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huachun Zhang
- Department of Nursing, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Zhao M, Xiao M, Tan Q, Lyu J, Lu F. The effect of aerobic exercise on oxidative stress in patients with chronic kidney disease: a systematic review and meta-analysis with trial sequential analysis. Ren Fail 2023; 45:2252093. [PMID: 37753870 PMCID: PMC10538458 DOI: 10.1080/0886022x.2023.2252093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate how aerobic exercise affects oxidative stress (OS) in patients with chronic kidney disease (CKD). METHODS Retrieval dates range from the date the database was established to 19 July 2023, without languages being restricted. A meta-analysis and sensitivity analysis were conducted using RevMan 5.3 and Stata 16.0. RESULTS The meta-analysis showed that, compared to usual activity or no exercise, aerobic exercise significantly reduced the oxidative markers malondialdehyde (MDA) (mean differences (MD) - 0.96 (95% CI -1.33, - 0.59); p < 0.00001), advanced oxidation protein product (AOPP) (MD - 3.49 (95% CI - 5.05, - 1.93); p < 0.00001), F2-isoprostanes (F2-iso) (MD - 11.02 (95% CI - 17.79, - 4.25); p = 0.001). Aerobic exercise also increased the antioxidant marker superoxide dismutase (SOD) in CKD patients (standardized mean differences (SMD) 1.30 (95% CI 0.56, 2.04); p = 0.0005). Subgroup analysis showed a significant increase in glutathione peroxidase (GPX) in patients aged ≥60 years (SMD 2.11 (95% CI 1.69, 2.54); p < 0.00001). The change in total antioxidant capacity (TAC) after aerobic exercise was insignificant in patients with CKD. The trial sequential analysis supported aerobic exercise's effectiveness in improving MDA, SOD, AOPP, and F2-iso in patients with CKD. CONCLUSION The results of this review suggest that aerobic exercise improves OS indicators (MDA, SOD, AOPP, and F2-iso) in CKD patients compared to conventional treatment or no exercise and that the effects on GPX and TAC indicators need further confirmation. For better validation of benefits and exploration of the best aerobic exercise regimen to improve OS status with CKD, further studies with high methodological quality and large sample sizes are needed.
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Affiliation(s)
- Mengjie Zhao
- Graduate School of Beijing University of Chinese Medicine, Beijing, P.R. China
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
| | - Mengli Xiao
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
| | - Qin Tan
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
| | - Jian Lyu
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
| | - Fang Lu
- NMPA Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
- National Clinical Research Center for Chinese Medicine Cardiology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, P.R. China
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Meléndez-Oliva E, Sánchez-Romero EA, Segura-Ortí E, Gil-Gómez JA, Soto-Goñi XA, Poveda-Pagán EJ. Effect of a Virtual Reality Exercise on Patients Undergoing Haemodialysis: A Randomised Controlled Clinical Trial Research Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4116. [PMID: 36901125 PMCID: PMC10002015 DOI: 10.3390/ijerph20054116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
High levels of inflammatory markers have been associated with a greater deterioration of renal function and cardiovascular morbidity and mortality. For its part, physical exercise has been shown to be beneficial in improving the functional, psychological, and inflammatory states of patients with chronic kidney failure (CKF) undergoing haemodialysis (HD) treatment, improving their health-related quality of life. In recent years, virtual reality (VR) has been studied and described as an effective and safe tool that improves patients' adherence to exercise programs. For these reasons, we propose to analyse the effect of VR exercise on the functional, psychological, and inflammatory states of patients on HD, as well as their levels of adherence to exercise, and compare them with static pedalling exercises. We will randomise 80 patients with CKF into two blind groups: an experimental group, which will carry out an intradialytic exercise program with non-immersive VR (n = 40), and a control group, which will exercise with a static pedal (n = 40). Functional capacity, inflammatory and phycological status, and exercise adherence will be analysed. Higher levels of adherence to exercise are expected in the VR group, which will have greater effects on the patients' functional capacity and psychological and inflammatory status.
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Affiliation(s)
- Erika Meléndez-Oliva
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
| | - Eleuterio A. Sánchez-Romero
- Department of Physiotherapy, Faculty of Sport Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Physiotherapy and Orofacial Pain Working Group, Sociedad Española de Disfunción Craneomandibular y Dolor Orofacial (SEDCYDO), 28009 Madrid, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, European University of Madrid, 28670 Madrid, Spain
- Department of Physiotherapy, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300 Santa Cruz de Tenerife, Spain
| | - Eva Segura-Ortí
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Xabier A. Soto-Goñi
- Department of Psychobiology, Complutense University of Madrid, 28040 Madrid, Spain
| | - Emilio J. Poveda-Pagán
- Center for Translational Research in Physiotherapy, Miguel Hernández University, San Juan, 03550 Alicante, Spain
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Junqué-Jiménez A, Esteve-Simó V, Andreu-Periz L, Segura-Ortí E. A nurse-led home-based exercise program for patients with chronic kidney disease. Worldviews Evid Based Nurs 2023; 20:79-88. [PMID: 36453565 DOI: 10.1111/wvn.12613] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 07/26/2022] [Accepted: 08/27/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Exercise programs in patients with kidney disease improve functional capacity and health-related quality of life, but the implementation of exercise programs in nephrology services is not an easy task. AIM To evaluate the effectiveness of a home-based exercise program in patients with chronic kidney disease (CKD) stages 4-5 (with or without dialysis). METHODS A 12-week prospective observational cohort design study was carried out with patients with renal failure who undertook a home-based exercise program. Registered data included: (a) biochemical parameters; (b) functional capacity tests, that is, short physical performance battery, sit to stand to sit 10, and 6-min walking test; (c) handgrip strength; (d) health-related quality of life; (e) satisfaction; and (f) adherence. The quantitative variables were expressed by means and standard deviation, and qualitative variables, by percentage. The comparison of quantitative data between baseline and at 12 weeks of the same group was carried out using the Wilcoxon test for nonparametric-related variables and the chi-square test for categorical variables using contingency tables. RESULTS Fifty-three patients were included (mean age = 67.4 years). The functional capacity tests showed a significant improvement in the short physical performance battery (8.3 ± 2.8 vs. 9.5 ± 2.6 points), the sit to stand to sit 10 (35.8 ± 17.7 vs. 31.8 ± 15.3 s), and the 6-min walking test (355.0 ± 106.1 vs. 386.4 ± 113.6 meters), mainly in CKD stage 5. There were no significant differences in handgrip and health-related quality of life. Regarding the degree of program satisfaction, 70% of the patients were very satisfied with being able to participate in the program, and 64% considered that they had more strength after completing the home-based exercise program. LINKING EVIDENCE TO ACTION The implementation of a home-based exercise program results in improved functional capacity in patients with CKD stage 5. Moreover, this exercise program is safe, and patients were satisfied.
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Affiliation(s)
- Anna Junqué-Jiménez
- Nephrology Department, Hospital de Terrassa, Consorci Sanitari de Terrassa (CST), Barcelona, Spain
| | - Vicent Esteve-Simó
- Nephrology Department, Hospital de Terrassa, Consorci Sanitari de Terrassa (CST), Barcelona, Spain
| | - Lola Andreu-Periz
- Nursing Department, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
| | - Eva Segura-Ortí
- Physiotherapy Department, Universidad Cardenal Herrera-CEU, CEU Universities, València, Spain
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