Results From a Physical Activity Intervention Feasibility Study With Kidney Inpatients

Area of Science:

• Nephrology
• Geriatrics
• Physical Therapy

Background:

• Patients with end-stage kidney disease (ESKD) on dialysis often experience physical inactivity, leading to reduced function, frailty, and diminished quality of life.
• Hospitalizations are common in this population, increasing healthcare costs and negatively impacting patient outcomes.
• Current standard care for dialysis patients does not typically include physical activity programs or assessments, despite their potential benefits.

Purpose of the Study:

• To evaluate the feasibility and preliminary efficacy of the 'Move More' early physical activity intervention for hospitalized patients requiring dialysis.
• To determine if the intervention meets predefined feasibility criteria for administration and patient participation.
• To explore potential benefits of the intervention on physical function, frailty, and quality of life in this patient group.

Main Methods:

• A single-arm pilot study involving kidney inpatients requiring dialysis at Foothills Medical Center, Calgary.
• An individualized, daily in-hospital physical activity intervention focusing on strength, mobility, and balance, led by a kinesiologist.
• Feasibility was assessed through recruitment, participation rates, assessment completion, and adverse events. Patient and healthcare practitioner satisfaction were surveyed.

Main Results:

• Recruitment consent (36%) and intervention completion (78%) did not meet the a priori feasibility targets (60% and 80%, respectively).
• Assessment completion rates were high pre-intervention (95%) but lower post-intervention (65%).
• High satisfaction was reported by participants (100%) and staff (77%). No adverse events occurred. Preliminary improvements in frailty and quality of life were observed.

Conclusions:

• Initial implementation of the physical activity intervention faced challenges with recruitment and adherence, indicating it was not initially feasible.
• Modifications, including dedicated research staff on the unit, improved recruitment efforts and adherence support.
• The intervention shows promise for improving frailty and quality of life in kidney inpatients on dialysis, though further research with a control group is needed.