In the Journals

Exercise rehabilitation program may present long-term benefits to patients with CKD

Clara Bohm
Clara Bohm

Patients with CKD who attended a 10-week exercise rehabilitation program were more likely to continue exercising at 1 year than those who did not attend the program, according to a study published in Clinical Kidney Journal. Participation may also be associated with improved physical function.

“To our knowledge, this is the first study to evaluate the long-term effect of a clinical exercise rehabilitation program on physical function in individuals with CKD,” Nicholas Hargrove, of Max Rady College of Medicine at the University of Manitoba in Canada, and colleagues wrote. “In addition, the diversity of the study population in terms of age, sex, race, CKD stage and comorbidities resulted in a sample that was more characteristic of the general CKD population than previous investigations, which were predominately focused on CKD stages 3 and 4, maximizing generalizability.”

To evaluate the impact of an exercise rehabilitation program on physical function, researchers divided adults with CKD who were registered in the Manitoba Renal Program from January 2011 to March 2016 into the attenders group (n = 53) or one of two control groups which included the non-attenders (n = 40) and the CanFIT Controls (individuals with CKD enrolled in a concurrent longitudinal observational study of frailty status; n = 207).

Attenders consisted of individuals who were referred to and attended the 10-week exercise rehabilitation program. The program included weekly classes of 1 hour of education and 1 hour of group fitness activity (aerobics and strength training). They first attended an exercise counseling clinic. Non-attenders also attended the exercise counseling clinic and were referred to the rehabilitation program but did not attend. The CanFIT participants did not attend either counseling or rehabilitation.

The primary outcome of the study was change in physical function based on short physical performance battery score. Secondary outcomes included change in health-related quality of life, physical activity behavior, exercise behavior and hospitalization over 1 year.

Researchers observed no significant differences between the three groups in any of the secondary outcomes except for physical activity behavior where 35% of non-attenders and 60% of attenders were found to be exercising regularly at 1 year.

Man being assisted in lifting weights 
Patients with CKD who attended a 10-week exercise rehabilitation program were more likely to continue exercising at 1 year than those who did not attend the program.
Source: Adobe Stock

Further, although mean change in short physical performance battery score over 1 year was not significantly different between groups, researchers found that attenders with baselines scores less than 12 trended toward increased likelihood of improved score at 1 year (OR = 2.18; 95% CI, 0.95-5.02) and that participation in the program may be associated with a clinically meaningful change in short physical performance battery score compared with those who did not attend the program.

"In 'real-world' conditions, attendance at a single 10 week session of exercise rehabilitation appears to be associated with sustained exercise participation and improved physical function over time," Clara Bohm, MD, MPH, assistant professor at the University of Manitoba and nephrologist at the Manitoba Renal Program, told Healio/Nephrology. "Future studies with larger sample sizes are needed to confirm the above observations and determine if the effects of exercise rehabilitation persist for longer than 1 year and if benefits to physical function translate to a decrease in hospitalization and mortality over the long term. In addition, studies that investigate how barriers to attending exercise programs can be overcome for individuals with CKD are needed. Finally, research that examines the effect of exercise rehabilitation on patient-important outcomes is needed." – by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.

Clara Bohm
Clara Bohm

Patients with CKD who attended a 10-week exercise rehabilitation program were more likely to continue exercising at 1 year than those who did not attend the program, according to a study published in Clinical Kidney Journal. Participation may also be associated with improved physical function.

“To our knowledge, this is the first study to evaluate the long-term effect of a clinical exercise rehabilitation program on physical function in individuals with CKD,” Nicholas Hargrove, of Max Rady College of Medicine at the University of Manitoba in Canada, and colleagues wrote. “In addition, the diversity of the study population in terms of age, sex, race, CKD stage and comorbidities resulted in a sample that was more characteristic of the general CKD population than previous investigations, which were predominately focused on CKD stages 3 and 4, maximizing generalizability.”

To evaluate the impact of an exercise rehabilitation program on physical function, researchers divided adults with CKD who were registered in the Manitoba Renal Program from January 2011 to March 2016 into the attenders group (n = 53) or one of two control groups which included the non-attenders (n = 40) and the CanFIT Controls (individuals with CKD enrolled in a concurrent longitudinal observational study of frailty status; n = 207).

Attenders consisted of individuals who were referred to and attended the 10-week exercise rehabilitation program. The program included weekly classes of 1 hour of education and 1 hour of group fitness activity (aerobics and strength training). They first attended an exercise counseling clinic. Non-attenders also attended the exercise counseling clinic and were referred to the rehabilitation program but did not attend. The CanFIT participants did not attend either counseling or rehabilitation.

The primary outcome of the study was change in physical function based on short physical performance battery score. Secondary outcomes included change in health-related quality of life, physical activity behavior, exercise behavior and hospitalization over 1 year.

Researchers observed no significant differences between the three groups in any of the secondary outcomes except for physical activity behavior where 35% of non-attenders and 60% of attenders were found to be exercising regularly at 1 year.

Man being assisted in lifting weights 
Patients with CKD who attended a 10-week exercise rehabilitation program were more likely to continue exercising at 1 year than those who did not attend the program.
Source: Adobe Stock

Further, although mean change in short physical performance battery score over 1 year was not significantly different between groups, researchers found that attenders with baselines scores less than 12 trended toward increased likelihood of improved score at 1 year (OR = 2.18; 95% CI, 0.95-5.02) and that participation in the program may be associated with a clinically meaningful change in short physical performance battery score compared with those who did not attend the program.

"In 'real-world' conditions, attendance at a single 10 week session of exercise rehabilitation appears to be associated with sustained exercise participation and improved physical function over time," Clara Bohm, MD, MPH, assistant professor at the University of Manitoba and nephrologist at the Manitoba Renal Program, told Healio/Nephrology. "Future studies with larger sample sizes are needed to confirm the above observations and determine if the effects of exercise rehabilitation persist for longer than 1 year and if benefits to physical function translate to a decrease in hospitalization and mortality over the long term. In addition, studies that investigate how barriers to attending exercise programs can be overcome for individuals with CKD are needed. Finally, research that examines the effect of exercise rehabilitation on patient-important outcomes is needed." – by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.