TY - JOUR
T1 - The PrEscription of intraDialytic exercise to improve quAlity of Life in patients with chronic kidney disease trial
T2 - study design and baseline data for a multicentre randomized controlled trial
AU - Greenwood, Sharlene A.
AU - Koufaki, Pelagia
AU - Macdonald, Jamie
AU - Bhandari, Sunil
AU - Burton, James
AU - Dasgupta, Indranil
AU - Farrington, Kenneth
AU - Ford, Ian
AU - Kalra, Philip A.
AU - Kean, Sharon
AU - Kumwenda, Mick
AU - Macdougall, Iain C.
AU - Messow, Claudia Martina
AU - Mitra, Sandip
AU - Reid, Chante
AU - Smith, Alice C.
AU - Taal, Maarten W.
AU - Thomson, Peter C.
AU - Wheeler, David C.
AU - White, Claire
AU - Yaqoob, Magdi
AU - Mercer, Thomas H.
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2021/5/1
Y1 - 2021/5/1
N2 - Background. Exercise interventions designed to improve physical function and reduce sedentary behaviour in haemodialysis (HD) patients might improve exercise capacity, reduce fatigue and lead to improved quality of life (QOL). The PrEscription of intraDialytic exercise to improve quAlity of Life study aimed to evaluate the effectiveness of a 6-month intradialytic exercise programme on QOL and physical function, compared with usual care for patients on HD in the UK. Methods. We conducted a prospective, pragmatic multicentre randomized controlled trial in 335 HD patients and randomly (1:1) assigned them to either (i) intradialytic exercise training plus usual care maintenance HD or (ii) usual care maintenance HD. The primary outcome of the study was the change in Kidney Disease Quality of Life Short Form (KDQOLSF 1.3) Physical Component Score between baseline and 6 months. Additional secondary outcomes included changes in peak aerobic capacity, physical fitness, habitual physical activity levels and falls (International Physical Activity Questionnaire, Duke's Activity Status Index and Tinetti Falls Efficacy Scale), QOL and symptom burden assessments (EQ5D), arterial stiffness (pulse wave velocity), anthropometric measures, resting blood pressure, clinical chemistry, safety and harms associated with the intervention, hospitalizations and cost-effectiveness. A nested qualitative study investigated the experience and acceptability of the intervention for both participants and members of the renal health care team. Results. At baseline assessment, 62.4% of the randomized cohort were male, the median age was 59.3 years and 50.4% were white. Prior cerebrovascular events and myocardial infarction were present in 8 and 12% of the cohort, respectively, 77.9% of patients had hypertension and 39.4% had diabetes. Baseline clinical characteristics and laboratory data for the randomized cohort were generally concordant with data from the UK Renal Registry. Conclusion. The results from this study will address a significant knowledge gap in the prescription of exercise interventions for patients receiving maintenance HD therapy and inform the development of intradialytic exercise programmes both nationally and internationally.
AB - Background. Exercise interventions designed to improve physical function and reduce sedentary behaviour in haemodialysis (HD) patients might improve exercise capacity, reduce fatigue and lead to improved quality of life (QOL). The PrEscription of intraDialytic exercise to improve quAlity of Life study aimed to evaluate the effectiveness of a 6-month intradialytic exercise programme on QOL and physical function, compared with usual care for patients on HD in the UK. Methods. We conducted a prospective, pragmatic multicentre randomized controlled trial in 335 HD patients and randomly (1:1) assigned them to either (i) intradialytic exercise training plus usual care maintenance HD or (ii) usual care maintenance HD. The primary outcome of the study was the change in Kidney Disease Quality of Life Short Form (KDQOLSF 1.3) Physical Component Score between baseline and 6 months. Additional secondary outcomes included changes in peak aerobic capacity, physical fitness, habitual physical activity levels and falls (International Physical Activity Questionnaire, Duke's Activity Status Index and Tinetti Falls Efficacy Scale), QOL and symptom burden assessments (EQ5D), arterial stiffness (pulse wave velocity), anthropometric measures, resting blood pressure, clinical chemistry, safety and harms associated with the intervention, hospitalizations and cost-effectiveness. A nested qualitative study investigated the experience and acceptability of the intervention for both participants and members of the renal health care team. Results. At baseline assessment, 62.4% of the randomized cohort were male, the median age was 59.3 years and 50.4% were white. Prior cerebrovascular events and myocardial infarction were present in 8 and 12% of the cohort, respectively, 77.9% of patients had hypertension and 39.4% had diabetes. Baseline clinical characteristics and laboratory data for the randomized cohort were generally concordant with data from the UK Renal Registry. Conclusion. The results from this study will address a significant knowledge gap in the prescription of exercise interventions for patients receiving maintenance HD therapy and inform the development of intradialytic exercise programmes both nationally and internationally.
KW - chronic kidney disease
KW - end-stage renal failure
KW - exercise
KW - haemodialysis
KW - physical activity
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85108510937&partnerID=8YFLogxK
U2 - 10.1093/ckj/sfaa107
DO - 10.1093/ckj/sfaa107
M3 - Article
AN - SCOPUS:85108510937
SN - 2048-8505
VL - 14
SP - 1345
EP - 1355
JO - Clinical Kidney Journal
JF - Clinical Kidney Journal
IS - 5
ER -
