Exercise training in CKD: efficacy, adherence, and safety

Erin J Howden, Jeff S Coombes, Haakan Strand, Bettina Douglas, Katrina L Campbell, Nicole M Isbel

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32 Citations (Scopus)

Abstract

BACKGROUND: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.

STUDY DESIGN: Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).

SETTING & PARTICIPANTS: Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.

INTERVENTION: Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.

OUTCOMES & MEASUREMENTS: Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.

RESULTS: 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36; control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3; post, 9.7±3.6), 6-minute walk distance (pre, 485±110m; post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2); post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.

LIMITATIONS: This study was not powered to evaluate the safety of exercise training on serious adverse events.

CONCLUSIONS: The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.

Original languageEnglish
Pages (from-to)583-591
Number of pages9
JournalAmerican Journal of Kidney Diseases
Volume65
Issue number4
DOIs
Publication statusPublished - Apr 2015
Externally publishedYes

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Chronic Renal Insufficiency
Exercise
Safety
Metabolic Equivalent
Life Style
Nurse Practitioners
Hand Strength
Ambulatory Care Facilities
Tertiary Care Centers
Body Mass Index
Cardiovascular Diseases
Randomized Controlled Trials
Population

Cite this

Howden, Erin J ; Coombes, Jeff S ; Strand, Haakan ; Douglas, Bettina ; Campbell, Katrina L ; Isbel, Nicole M. / Exercise training in CKD : efficacy, adherence, and safety. In: American Journal of Kidney Diseases. 2015 ; Vol. 65, No. 4. pp. 583-591.
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abstract = "BACKGROUND: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.STUDY DESIGN: Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).SETTING & PARTICIPANTS: Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.INTERVENTION: Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.OUTCOMES & MEASUREMENTS: Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.RESULTS: 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36; control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3; post, 9.7±3.6), 6-minute walk distance (pre, 485±110m; post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2); post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.LIMITATIONS: This study was not powered to evaluate the safety of exercise training on serious adverse events.CONCLUSIONS: The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.",
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Howden, EJ, Coombes, JS, Strand, H, Douglas, B, Campbell, KL & Isbel, NM 2015, 'Exercise training in CKD: efficacy, adherence, and safety' American Journal of Kidney Diseases, vol. 65, no. 4, pp. 583-591. https://doi.org/10.1053/j.ajkd.2014.09.017

Exercise training in CKD : efficacy, adherence, and safety. / Howden, Erin J; Coombes, Jeff S; Strand, Haakan; Douglas, Bettina; Campbell, Katrina L; Isbel, Nicole M.

In: American Journal of Kidney Diseases, Vol. 65, No. 4, 04.2015, p. 583-591.

Research output: Contribution to journalArticleResearchpeer-review

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AU - Howden, Erin J

AU - Coombes, Jeff S

AU - Strand, Haakan

AU - Douglas, Bettina

AU - Campbell, Katrina L

AU - Isbel, Nicole M

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N2 - BACKGROUND: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.STUDY DESIGN: Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).SETTING & PARTICIPANTS: Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.INTERVENTION: Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.OUTCOMES & MEASUREMENTS: Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.RESULTS: 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36; control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3; post, 9.7±3.6), 6-minute walk distance (pre, 485±110m; post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2); post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.LIMITATIONS: This study was not powered to evaluate the safety of exercise training on serious adverse events.CONCLUSIONS: The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.

AB - BACKGROUND: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.STUDY DESIGN: Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).SETTING & PARTICIPANTS: Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.INTERVENTION: Lifestyle intervention included access to multidisciplinary care through a nurse practitioner-led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.OUTCOMES & MEASUREMENTS: Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.RESULTS: 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n=36; control, n=36). The intervention resulted in a significant improvement in METs (pre, 7.2±3.3; post, 9.7±3.6), 6-minute walk distance (pre, 485±110m; post, 539±82m), and body mass index (pre, 32.5±6.7kg/m(2); post, 31.9±7.3kg/m(2)). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.LIMITATIONS: This study was not powered to evaluate the safety of exercise training on serious adverse events.CONCLUSIONS: The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.

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