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Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study

  • Nephrology – Original Paper
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Abstract

Objective

Evaluate the feasibility of implementing a combined in-hospital and home-based exercise program in older hemodialysis (HD) patients.

Design

A prospective longitudinal 12-week pilot study.

Setting

A university hospital HD unit and patients’ homes.

Participants

A convenience sample of nine older (>55 years) patients undergoing HD.

Interventions

An individualized exercise program performed on HD days (3/week) and at home (2–3/week), including aerobic, flexibility, strength exercises and patient education.

Main outcome measures

Feasibility measure: patient participation. Exercise performance: Duke Activity Status Index (DASI); 2-min walk test (2MWT); Timed-up-and-go (TUG). Quality of life: The Illness Intrusiveness Ratings Scale (IIRS); The Kidney Disease Quality of Life Questionnaire (KDQOL).

Results

The mean (SD) age of the patients was 68.1 (7.1). Participation in the in-hospital supervised exercise program was high, with patients exercising during 89% of HD sessions, but was lower for the unsupervised home-based component (56% exercised ≥ 2 times/week). Patients showed a gradual increase in the amount of exercise performed over 12 weeks. The 2MWT, TUG, IIRS and the KDQOL physical composite score demonstrated moderate responsiveness, while the DASI score exhibited only limited responsiveness.

Conclusions

This exercise program and the outcome measures were feasible for older HD patients: in-hospital participation was high, and physical performance and QOL measures exhibited moderate levels of responsiveness. Future, larger studies are needed to demonstrate whether intra-dialysis exercise, with or without home exercise, can lead to improved outcomes in this population.

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Acknowledgments

This study received funding from the Canadian Institutes of Health Research Institute of Aging Pilot Project (IAP-73373). Dr. Naglie is supported by the Mary Trimmer Chair in Geriatric Medicine Research, University of Toronto. Dr. Brooks is supported by The Canada Research Chair in Rehabilitation for Chronic Obstructive Pulmonary Disease. Dr. Kontos is supported by a Canadian Institutes of Health Research New Investigator Award (2009–2014, MSH-87726).

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Authors and Affiliations

  1. Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ON, M5G 2A2, Canada

    Mika L. Nonoyama, Dina Brooks, Alexandra Ponikvar, S. Vanita Jassal, Pia Kontos & Gary Naglie

  2. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada

    Dina Brooks

  3. Department of Medicine, University of Toronto, Toronto, ON, Canada

    S. Vanita Jassal & Gary Naglie

  4. Division of Nephrology, University Health Network, Toronto, ON, Canada

    S. Vanita Jassal

  5. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Pia Kontos

  6. Ontario Cancer Institute, Toronto, ON, Canada

    Gerald M. Devins

  7. Psychosocial Oncology and Palliative Care Program, Princess Margaret Hospital, Toronto, ON, Canada

    Gerald M. Devins

  8. Departments of Psychiatry and Psychology, University of Toronto, Toronto, ON, Canada

    Gerald M. Devins

  9. Acute Medicine Program, Joseph Brant Memorial Hospital, Burlington, ON, Canada

    Lily Spanjevic

  10. Faculty of Nursing, University of Toronto, Toronto, ON, Canada

    Lily Spanjevic

  11. Allied Health, University Health Network, Toronto, ON, Canada

    Carol Heck

  12. Interprofessional Research, Women’s College Hospital, Toronto, ON, Canada

    Judi Laprade

  13. Department of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada

    Gary Naglie

  14. Division of General Internal Medicine, University Health Network, Toronto, ON, Canada

    Gary Naglie

  15. Toronto General Research Institute, Toronto, ON, Canada

    Gary Naglie

Authors
  1. Mika L. Nonoyama
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  2. Dina Brooks
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  3. Alexandra Ponikvar
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  4. S. Vanita Jassal
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  5. Pia Kontos
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  6. Gerald M. Devins
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  7. Lily Spanjevic
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  8. Carol Heck
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  9. Judi Laprade
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  10. Gary Naglie
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Corresponding author

Correspondence to Gary Naglie.

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Nonoyama, M.L., Brooks, D., Ponikvar, A. et al. Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study. Int Urol Nephrol 42, 1125–1130 (2010). https://doi.org/10.1007/s11255-010-9718-7

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  • DOI: https://doi.org/10.1007/s11255-010-9718-7

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