A Prospective 2-site Parallel Intervention Trial of a Research-based Film to Increase Exercise Amongst Older Hemodialysis Patients

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2017 Jan 27

PMID 28122510

Citations 2

Authors

Pia Kontos

Shabbir M H Alibhai

Karen-Lee Miller

Dina Brooks

Romeo Colobong

Trisha Parsons

Sarbjit Vanita Jassal

Alison Thomas

Malcolm Binns

Gary Naglie

Affiliations

Soon will be listed here.

Abstract

Background: Evidence suggests that exercise training for hemodialysis patients positively improves morbidity and mortality outcomes, yet exercise programs remain rare and are not systematically incorporated into care. We developed a research-based film, Fit for Dialysis, designed to introduce, motivate, and sustain exercise for wellness amongst older hemodialysis patients, and exercise counseling and support by nephrologists, nurses, and family caregivers. The objective of this clinical trial is to determine whether and in what ways Fit for Dialysis improves outcomes and influences knowledge/attitudes regarding the importance of exercise for wellness in the context of end-stage renal disease.

Methods/design: This 2-site parallel intervention trial will recruit 60 older hemodialysis patients from two urban hospitals. The trial will compare the film + a 16-week exercise program in one hospital, with a 16-week exercise-only program in another hospital. Physical fitness and activity measures will be performed at baseline, 8 and 16 weeks, and 12 weeks after the end of the program. These include the 2-min Walk Test, Grip Strength, Duke Activity Status Index, and the Timed Up-and-Go Test, as well as wearing a pedometer for one week. Throughout the 16-week exercise program, and at 12 weeks after, we will record patients' exercise using the Godin Leisure-time Exercise Questionnaire. Patients will also keep a diary of the exercise that they do at home on non-dialysis days. Qualitative interviews, conducted at baseline, 8, and 16 weeks, will explore the impact of Fit for Dialysis on the knowledge/attitudes of patients, family caregivers, and nephrology staff regarding exercise for wellness, and in what ways the film is effective in educating, motivating, or sustaining patient exercise during dialysis, at home, and in the community.

Discussion: This research will determine for whom Fit for Dialysis is effective, why, and under what conditions. If Fit for Dialysis is proven beneficial to patients, nephrology staff and family caregivers, research-based film as a model to support exercise promotion and adherence could be used to support the National Kidney Foundation's guideline recommendation (NKF-KDOQI) that exercise be incorporated into the care and treatment of dialysis patients.

Trial Registration: NCT02754271 (ClinicalTrials.gov), retroactively registered on April 21, 2016.

Citing Articles

Frailty, Quality of Life, Anxiety, and Other Factors Affecting Adherence to Physical Activity Recommendations by Hemodialysis Patients.

Hornik B, Dulawa J Int J Environ Res Public Health. 2019; 16(10).

PMID: 31126041 PMC: 6571908. DOI: 10.3390/ijerph16101827.

Fit for Dialysis: a qualitative exploration of the impact of a research-based film for the promotion of exercise in hemodialysis.

Kontos P, Grigorovich A, Colobong R, Miller K, Nesrallah G, Binns M BMC Nephrol. 2018; 19(1):195.

PMID: 30081845 PMC: 6091204. DOI: 10.1186/s12882-018-0984-4.

References

Parsons T, Toffelmire E, King-VanVlack C . The effect of an exercise program during hemodialysis on dialysis efficacy, blood pressure and quality of life in end-stage renal disease (ESRD) patients. Clin Nephrol. 2004; 61(4):261-74. DOI: 10.5414/cnp61261. View

Santa Mina D, Alibhai S M, Matthew A, Guglietti C, Pirbaglou M, Trachtenberg J . A randomized trial of aerobic versus resistance exercise in prostate cancer survivors. J Aging Phys Act. 2012; 21(4):455-78. DOI: 10.1123/japa.21.4.455. View

Headley S, Germain M, Mailloux P, Mulhern J, Ashworth B, Burris J . Resistance training improves strength and functional measures in patients with end-stage renal disease. Am J Kidney Dis. 2002; 40(2):355-64. DOI: 10.1053/ajkd.2002.34520. View

Parsons J, Lavery J . Brokered dialogue: A new research method for controversial health and social issues. BMC Med Res Methodol. 2012; 12:92. PMC: 3426478. DOI: 10.1186/1471-2288-12-92. View

Barcellos F, Santos I, Umpierre D, Bohlke M, Hallal P . Effects of exercise in the whole spectrum of chronic kidney disease: a systematic review. Clin Kidney J. 2015; 8(6):753-65. PMC: 4655802. DOI: 10.1093/ckj/sfv099. View

Miller B, Cress C, Johnson M, Nichols D, Schnitzler M . Exercise during hemodialysis decreases the use of antihypertensive medications. Am J Kidney Dis. 2002; 39(4):828-33. DOI: 10.1053/ajkd.2002.32004. View

Carnes D, Mullinger B, Underwood M . Defining adverse events in manual therapies: a modified Delphi consensus study. Man Ther. 2009; 15(1):2-6. DOI: 10.1016/j.math.2009.02.003. View

Shapiro J, Hunt L . All the world's a stage: the use of theatrical performance in medical education. Med Educ. 2003; 37(10):922-7. DOI: 10.1046/j.1365-2923.2003.01634.x. View

Bohm C, Stewart K, Onyskie-Marcus J, Esliger D, Kriellaars D, Rigatto C . Effects of intradialytic cycling compared with pedometry on physical function in chronic outpatient hemodialysis: a prospective randomized trial. Nephrol Dial Transplant. 2014; 29(10):1947-55. DOI: 10.1093/ndt/gfu248. View

10.

Mason J, Khunti K, Stone M, Farooqi A, Carr S . Educational interventions in kidney disease care: a systematic review of randomized trials. Am J Kidney Dis. 2008; 51(6):933-51. DOI: 10.1053/j.ajkd.2008.01.024. View

11.

Leung A, Chan K, Sykes K, Chan K . Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients. Chest. 2006; 130(1):119-25. DOI: 10.1378/chest.130.1.119. View

12.

Carter R, Holiday D, Grothues C, Nwasuruba C, Stocks J, Tiep B . Criterion validity of the Duke Activity Status Index for assessing functional capacity in patients with chronic obstructive pulmonary disease. J Cardiopulm Rehabil. 2002; 22(4):298-308. DOI: 10.1097/00008483-200207000-00014. View

13.

Dousdampanis P, Trigka K, Fourtounas C . Diagnosis and management of chronic kidney disease in the elderly: a field of ongoing debate. Aging Dis. 2012; 3(5):360-72. PMC: 3501392. View

14.

Kontos P, Mitchell G, Mistry B, Ballon B . Using drama to improve person-centred dementia care. Int J Older People Nurs. 2010; 5(2):159-68. PMC: 3786173. DOI: 10.1111/j.1748-3743.2010.00221.x. View

15.

Thabane L, Ma J, Chu R, Cheng J, Ismaila A, Rios L . A tutorial on pilot studies: the what, why and how. BMC Med Res Methodol. 2010; 10:1. PMC: 2824145. DOI: 10.1186/1471-2288-10-1. View

16.

de Blok B, de Greef M, Ten Hacken N, Sprenger S, Postema K, Wempe J . The effects of a lifestyle physical activity counseling program with feedback of a pedometer during pulmonary rehabilitation in patients with COPD: a pilot study. Patient Educ Couns. 2006; 61(1):48-55. DOI: 10.1016/j.pec.2005.02.005. View

17.

Idier L, Untas A, Koleck M, Chauveau P, Rascle N . Assessment and effects of Therapeutic Patient Education for patients in hemodialysis: a systematic review. Int J Nurs Stud. 2011; 48(12):1570-86. DOI: 10.1016/j.ijnurstu.2011.08.006. View

18.

Konstantinidou E, Koukouvou G, Kouidi E, Deligiannis A, Tourkantonis A . Exercise training in patients with end-stage renal disease on hemodialysis: comparison of three rehabilitation programs. J Rehabil Med. 2002; 34(1):40-5. DOI: 10.1080/165019702317242695. View

19.

Borg G . Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14(5):377-81. View

20.

Stephenson L, Bebb D, Reimer R, Culos-Reed S . Physical activity and diet behaviour in colorectal cancer patients receiving chemotherapy: associations with quality of life. BMC Gastroenterol. 2009; 9:60. PMC: 2727528. DOI: 10.1186/1471-230X-9-60. View