Prof Paul Bennett1, Mr Michael West1, Dr Wael Hussein1, Dr Brigitte Schiller1
1Satellite Healthcare, San Jose, United States
Background: Patients undergoing peritoneal dialysis (PD) are physically inactive, resulting in reduced physical function and quality of life. This study tested the feasibility and measured the effect of a combined resistance and cardiovascular exercise program on physical function and patient reported outcome measures (PROMs).
Methods: Randomized controlled trial. Intervention (I) group received monthly exercise physiologist consultations, exercise prescription (resistance and aerobic exercise program using exercise bands) and weekly phone calls over 12 weeks. Control (C) group received usual care. Feasibility outcomes were eligibility, recruitment rates, adherence and adverse events. Efficacy outcomes were change in physical function in I compared to the C group in 30 second sit to stand physical function test (STS30), pinch strength test (PST) and the 8 foot timed up and go test (TUG). PROMs were measured using the London Evaluation of Illness (LEVIL) instrument.
Results: From a single center with 78 PD patients, 29 (37%) did not meet inclusion criteria (16 medically unstable, 13 PD less than 6 weeks). 13 (17%) patients declined to participate resulting in a recruitment rate of 46% consisting of 36 patients randomized into 2 groups of 18 (1:1). 10 patients did not complete the study resulting in a retention rate of 72% and analyzable data for 26 patients (13 in each arm). 10 out of 13 (77%) intervention patients completed greater than 50% of sessions. No serious adverse events caused by the exercise program were reported. In all physical function measures the intervention exercise group improved more than the control group without reached statistical significance. PROMs improved in the exercise group and worsened in the control group in the domains of wellbeing, fatigue, breathlessness and appetite; sleep improved more in the exercise group; and pain worsened more in the control group.
Conclusion: A resistance and cardiovascular exercise program is feasible and safe and resulted in increased physical activity and physical function in PD patients. a starting sample of 86, would be required to detect of 2 sit to stand repetitions.
Director of Medical & Clinical Affairs at Satellite Healthcare, California
Chair, International Society of Nephrology Kidney Health Professionals Working Group
Chair, Global Renal Exercise Group
Honorary Professor, Deakin University