Development and Testing of an Innovative Patient-Centered Physical Activity Program for Hemodialysis Patients
University of Arizona
Summary
The goal of this clinical trial is to compare the efficacy of a standard intradialytic exercise program (control group) to an individualized, patient-centered, "Move-More" physical activity intervention (intervention group) in hemodialysis (HD) patients. Exercise programs often fail to yield robust benefits for many HD patients, in part because the type and volume of exercise prescribed is inappropriate for a variety of reasons, and the benefits from these studies are often disappointing, as they are characterized by poor adherence, high dropout rates, and modest effects on physical function, body composition, cardiovascular disease risk, and other outcomes related to quality of life (QOL). To address this, the investigators have designed a novel physical activity intervention "Move More" that is designed to overcome many of the barriers to increasing physical activity in this population. This study aims to compare the efficacy of a standard intradialytic exercise program (control group) to an individualized, patient-centered, "Move-More" physical activity intervention (intervention group) in HD patients. The investigators primary hypothesis is that patients randomized to the Move More intervention will increase their physical activity levels more than those in the intradialytic exercise group. The main question it aims to answer is: • Does "Move More" increase the physical activity levels (minutes) measured through weekly minutes of physical activity and the LoPAQ questionnaire more than those in the standard intradialytic exercise program? For secondary outcomes this study aims to answer the following: * Does "Move More" improve the physical function of hemodialysis patients assessed by the short physical performance battery (SPBB) more than those in the standard intradialytic exercise program? * Does "Move More" decrease fatigue assess by the SONG-HD survey more than those in the standard intradialytic exercise program? * Does "Move More" decrease symptoms of depression assessed by PROMIS Depression Short Form 8a more than those in the standard intradialytic exercise program? * Does "Move More" increase the amount of exercise measured through a point system more than those in the standard intradialytic exercise program? * Does "Move More" improve blood pressure (BP) more than those in the standard intradialytic exercise program?
Description
Individuals with kidney failure receiving maintenance hemodialysis (HD) have very low physical activity levels and poor physical function, and this contributes to a poor quality of life and premature mortality. To help address this problem, many researchers and clinicians have implemented simplistic physical activity programs that include mandated exercise prescriptions such as cycling during dialysis, light resistance training, or at-home walking programs. But the benefits from these studies are often disappointing, as they are characterized by poor adherence, high dropout rates, and modest e…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * ≥ 18 years old (no upper age limit); * Chronic hemodialysis for ≥ 3 months; * No planned or expected change in dialysis modality, elective surgery, or relocation during the study period (24 weeks); * Able to communicate in English or Spanish and provide written informed consent; * Assessed to be safe and able to exercise by the Hemodialysis unit nephrologist Exclusion Criteria: * Physical Activity: patients undergoing \>150 minutes/week of prescribed PA at baseline will be excluded from the study. * Physician Clearance: Patients who do not receive physician clearance t…
Interventions
- Behavioral"Move More" Personalized Exercise Program
"Move More" - a personalized exercise program involving both in center and out-of-center exercise. Our novel intervention provides patient's the autonomy to choose the types of physical activity and exercise that they are willing and able to participate in. In brief, it involves working one-on-one with patients to develop an activity prescription that aims to get participants to "move more", by any means necessary.
- BehavioralIntradialytic Exercise Program
Those in the intradialytic exercise group will undergo a variety of exercises including intradialytic cycling and resistance ("strength training").
Location
- DCI Desert DialysisTucson, Arizona