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Yamaguchi T, Yabe H, Mitake Y, Fujii T. Factors associated with dropout from physical function assessment programs among participants receiving maintenance hemodialysis: A retrospective observational cohort study. Ther Apher Dial 2021; 26:409-416. [PMID: 34402198 DOI: 10.1111/1744-9987.13725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 11/26/2022]
Abstract
We aimed to investigate the factors associated with dropout from a physical function assessment program among participants receiving outpatient hemodialysis (HD). The participants were divided into continuation and dropout groups and followed up for 3 years after the initial physical function assessment. Multivariate logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the dropout group to determine the factors associated with dropout from the physical function assessment program. The continuation and dropout groups included 43 and 58 participants, respectively. The continuation group had a significantly higher self-efficacy (SE) and age than the dropout group (p = 0.001, p = 0.047). Multivariate logistic regression analysis indicated that only SE (OR: 1.202, 95% CI: 1.082-1.334) remained a significant predictor after adjustment (p < 0.05). There is a need to evaluate SE to prevent dropout from physical functioning assessment programs.
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Affiliation(s)
- Tomoya Yamaguchi
- Department of Rehabilitation, Seirei Fukuroi Municipal Hospital, Shizuoka, Japan
| | - Hiroki Yabe
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Shizuoka, Japan
| | - Yuya Mitake
- Department of Rehabilitation, Seirei Sakura Citizen Hospital, Chiba, Japan
| | - Takayuki Fujii
- Department of Nephrology, Seirei Sakura Citizen Hospital, Chiba, Japan
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Larkin JW, Han M, Han H, Guedes MH, Gonçalves PB, Poli-de-Figueiredo CE, Cuvello-Neto AL, Barra ABL, de Moraes TP, Usvyat LA, Kotanko P, Canziani MEF, Raimann JG, Pecoits-Filho R. Impact of hemodialysis and post-dialysis period on granular activity levels. BMC Nephrol 2020; 21:197. [PMID: 32450793 PMCID: PMC7249440 DOI: 10.1186/s12882-020-01853-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 05/12/2020] [Indexed: 11/26/2022] Open
Abstract
Background Physical activity (PA) is typically lower on hemodialysis (HD) days. Albeit intradialytic inactivity is expected, it is unknown whether recovery after HD contributes to low PA. We investigated the impact of HD and post-HD period on granular PA relative to HD timing. Methods We used baseline data from the HDFIT trial conducted from August 2016 to October 2017. Accelerometry measured PA over 1 week in patients who received thrice-weekly high-flux HD (vintage 3 to 24 months), were clinically stable, and had no ambulatory limitations. PA was assessed on HD days (0 to ≤24 h after start HD), first non-HD days (> 24 to ≤48 h after start HD) and second non-HD day (> 48 to ≤72 h after start HD). PA was recorded in blocks/slices: 4 h during HD, 0 to ≤2 h post-HD (30 min slices), and > 2 to ≤20 h post-HD (4.5 h slices). Blocks/slices of PA were captured at concurrent/parallel times on first/second non-HD days compared to HD days. Results Among 195 patients (mean age 53 ± 15 years, 71% male), step counts per 24-h were 3919 ± 2899 on HD days, 5308 ± 3131 on first non-HD days (p < 0.001), and 4926 ± 3413 on second non-HD days (p = 0.032). During concurrent/parallel times to HD on first and second non-HD days, patients took 1308 and 1128 more steps (both p < 0.001). Patients took 276 more steps and had highest rates of steps/hour 2-h post-HD versus same times on first non-HD days (all p < 0.05). Consistent findings were observed on second non-HD days. Conclusions PA was higher within 2-h of HD versus same times on non-HD days. Lower PA on HD days was attributable to intradialytic inactivity. The established PA profiles are of importance to the design and development of exercise programs that aim to increase activity during and between HD treatments. Trial registration HDFIT was prospectively registered 20 April 2016 on ClinicalTrials.gov (NCT02787161)
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Affiliation(s)
- John W Larkin
- School of Medicine, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil. .,Global Medical Office, Fresenius Medical Care, Waltham, MA, USA.
| | - Maggie Han
- School of Medicine, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil.,Research Division, Renal Research Institute, New York, NY, USA
| | - Hao Han
- Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
| | - Murilo H Guedes
- School of Medicine, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | | | | | | | | | - Thyago Proença de Moraes
- School of Medicine, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
| | - Len A Usvyat
- Global Medical Office, Fresenius Medical Care, Waltham, MA, USA
| | - Peter Kotanko
- Research Division, Renal Research Institute, New York, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Roberto Pecoits-Filho
- School of Medicine, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Curitiba, PR, 80215-901, Brazil
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Han M, Ye X, Preciado P, Williams S, Campos I, Bonner M, Young C, Marsh D, Larkin JW, Usvyat LA, Maddux FW, Pecoits-Filho R, Kotanko P. Relationships between Neighborhood Walkability and Objectively Measured Physical Activity Levels in Hemodialysis Patients. Blood Purif 2018; 45:236-244. [PMID: 29478044 DOI: 10.1159/000485161] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Neighborhood walkability is associated with indicators of health in the general population. We explored the association between neighborhood walkability and daily steps in hemodialysis (HD) patients. METHODS We measured daily steps over 5 weeks using Fitbit Flex (Fitbit, San Francisco, CA, USA) and retrieved Walk Score® (WS) data by patient's home ZIP code (www.walkscore.com; 0 = poorest walkability; 100 = greatest walkability). RESULTS HD patients took a mean of 6,393 ± 3,550 steps/day (n = 46). Median WS of the neighborhood where they resided was 28. Patients in an above-median WS (n = 27) neighborhood took significantly more daily steps compared to those (n = 19) in a below-median WS neighborhood (7,514 ± 3,900 vs. 4,800 ± 2,228 steps/day; p < 0.001, t test). Daily steps and WS were directly correlated (R = 0.425; p = 0.0032, parametric test; R = 0.359, p = 0.0143, non-parametric test). CONCLUSION This is the first study conducted among HD patients to indicate a direct relationship between neighborhood walkability and the actual steps taken. These results should be considered when designing initiatives to increase and improvise exercise routines in HD populations.
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Affiliation(s)
- Maggie Han
- Renal Research Institute, New York, New York, USA
| | - Xiaoling Ye
- Renal Research Institute, New York, New York, USA
| | | | | | | | | | | | | | - John W Larkin
- Pontificia Universidade Catolica do Parana, Curitiba, Brazil.,Fresenius Medical Care North America, Waltham, Massachusetts, USA
| | - Len A Usvyat
- Fresenius Medical Care North America, Waltham, Massachusetts, USA
| | | | | | - Peter Kotanko
- Renal Research Institute, New York, New York, USA.,Icahn School of Medicine, New York, New York, USA
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Isnard-Rouchon M, Coutard C. [Exercise as a protective cardiovascular and metabolic factor in end stage renal disease patients]. Nephrol Ther 2017; 13:544-549. [PMID: 29126841 DOI: 10.1016/j.nephro.2017.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/11/2017] [Accepted: 01/21/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of the study was to test the effectiveness of Physical Activity (PA) during haemodialysis as a protective treatment against cardiovascular (CV) diseases. METHODS Eighty volunteer patients were included in this multicentric prospective study and followed for two years: 40 patients in the Exercise group (EX), 40 patients in the Control group (Ctrl). CV risk factors: Total Cholesterol, HDL Cholesterol (HDL-c), LDL cholesterol (LDL-c), Triglycerides (TG) and Hemoglobin (Hb), and Prealbumin, Albumin, Parathormon, 25-OH Vitamin D, were checked at Month 0 (M0) and Month 24 (M24). The number of antihypertensive treatments and the Erythropoietin Stimulating Agent (ESA) required doses were collected. We noted for each group during the follow-up the number of hospitalizations for CV reasons. After two years, we compared 31 patients in EX and 35 in Ctrl. RESULTS We observed a significant decrease of total cholesterol EX group: 1.86±0.49g/L at M0 versus 1.64±0.38g/L at M24 (P<0.05). HDLc and but LDL-c remained stable in both groups. TG decreased significantly in EX: 1.76±0.89g/L vs 1.44±0.69g/L (P<0.05). The number of antihypertensive drugs per patient decreased significantly (P<0.05) in the EX group between M0 and M24 (1.61±1.28 at M0 and 0.74±0.85 at M24). The EX patients were three times less frequently hospitalized for cardiovascular reasons. There were five hospital stays versus 14 for the Ctrl group. CONCLUSION Our study demonstrates that an intradialytic aerobic cycling training program promotes beneficial effects on cardiovascular protection. Physical activity reduced the number of CV events in our population during two years follow-up.
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Affiliation(s)
| | - Céline Coutard
- AURA Santé, 8, rue du Colombier, 63400 Chamalières, France
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