Randomized Trial—PrEscription of intraDialytic exercise to improve quAlity of Life in Patients Receiving Hemodialysis
| Autor: | Claire White, David C. Wheeler, Maarten W. Taal, James O. Burton, Ken Farrington, Mick Kumwenda, Thomas H. Mercer, Sandip Mitra, Iain C. Macdougall, Ian Ford, Sunil Bhandari, Alice C. Smith, Magdi Yaqoob, Claudia-Martina Messow, Philip A. Kalra, Pelagia Koufaki, Peter C. Thomson, Sharlene A. Greenwood, Indranil Dasgupta, Jamie H. Macdonald, Chante Reid, Sharon Kean |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
030232 urology & nephrology physical activity 030204 cardiovascular system & hematology rehabilitation law.invention 03 medical and health sciences physical function 0302 clinical medicine Randomized controlled trial Quality of life Clinical Research law medicine Aerobic exercise Medical prescription business.industry VO2 max medicine.disease R1 Nephrology Cohort Physical therapy Exercise prescription business chronic kidney disease Kidney disease |
| Zdroj: | Kidney International Reports |
| ISSN: | 2468-0249 |
| Popis: | Introduction Whether clinically implementable exercise interventions in people receiving hemodialysis (HD) therapy improve health-related quality of life (HRQoL) remains unknown. The PrEscription of intraDialytic exercise to improve quAlity of Life (PEDAL) study evaluated the clinical benefit and cost-effectiveness of a 6-month intradialytic exercise program. Methods In a multicenter, single-blinded, randomized, controlled trial, people receiving HD were randomly assigned to (i) intradialytic exercise training (exercise intervention group [EX]) and (ii) usual care (control group [CON]). Primary outcome was change in Kidney Disease Quality of Life Short-Form Physical Component Summary (KDQOL-SF 1.3 PCS) from baseline to 6 months. Cost-effectiveness was determined using health economic analysis; physiological impairment was evaluated by peak oxygen uptake; and harms were recorded. Results We randomized 379 participants; 335 and 243 patients (EX n = 127; CON n = 116) completed baseline and 6-month assessments, respectively. Mean difference in change PCS from baseline to 6 months between EX and CON was 2.4 (95% confidence interval [CI]: −0.1 to 4.8) arbitrary units (P = 0.055); no improvements were observed in peak oxygen uptake or secondary outcome measures. Participants in the intervention group had poor compliance (47%) and poor adherence (18%) to the exercise prescription. Cost of delivering intervention ranged from US$598 to US$1092 per participant per year. The number of participants with harms was similar between EX (n = 69) and CON (n = 56). A primary limitation was the lack of an attention CON. Many patients also withdrew from the study or were too unwell to complete all physiological outcome assessments. Conclusions A 6-month intradialytic aerobic exercise program was not clinically beneficial in improving HRQoL as delivered to this cohort of deconditioned patients on HD. Graphical abstract |
| Databáze: | OpenAIRE |
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