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Exercise and Muscle Performance01:27

Exercise and Muscle Performance

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Exercise induces a range of adaptations in muscle tissue, depending on the type and duration of activity. Such physical training can be broadly categorized into two types: endurance exercises and resistance exercises.
Endurance exercises
Endurance exercises involve running, swimming, or cycling, which require repetitive movements with low force output. When a person engages in endurance exercise, a few noticeable changes occur in their skeletal muscles. For instance, the number of capillaries...
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Factors Influencing Recruitment, Retention, and Adherence Rates in Exercise Interventions in ESKD: A Scoping Review.

Malvika Agarwal1, Jamie Alexiuk2, Clara Bohm3

  • 1Faculty of Medicine, University of Ottawa, Ontario, Canada.

Kidney Medicine
|January 15, 2025
PubMed
Summary

Exercise interventions for end-stage kidney disease (ESKD) patients show high recruitment and adherence. However, less than a quarter of studies report adherence rates, highlighting a need for standardized reporting in dialysis populations.

Keywords:
Adherencedialysisend-stage kidney disease (ESKD)exerciserecruitmentretention

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Area of Science:

  • Nephrology
  • Exercise Science
  • Public Health

Background:

  • Sedentary lifestyles are prevalent in end-stage kidney disease (ESKD) patients, increasing mortality and morbidity risks.
  • Personalized exercise programs may enhance participation and adherence in this population.
  • Understanding factors influencing exercise program engagement is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the impact of specific exercise intervention characteristics on recruitment, adherence, and completion rates in individuals with ESKD undergoing dialysis.
  • To identify key elements of exercise programs that promote engagement among dialysis patients.

Main Methods:

  • A scoping review of randomized controlled trials (RCTs) was conducted, searching major databases through May 2023.
  • Included RCTs involved adults with ESKD receiving dialysis, with interventions lasting ≥12 weeks and >10 participants per arm.
  • Data were synthesized qualitatively, with quantitative analysis (ANOVA) assessing associations between intervention characteristics and engagement rates. Risk of bias was evaluated using the Cochrane tool.

Main Results:

  • 55 studies involving 3,269 participants were included. Average recruitment, retention, and adherence rates were 77.4%, 81.2%, and 76.0%, respectively.
  • The majority of participants were male (63.2%) and on hemodialysis (89.1%), with a mean age of 56 years.
  • No significant associations were found between intervention characteristics (type, duration, frequency, setting, supervision) and recruitment, adherence, or retention rates. Only 27% of studies reported adherence.

Conclusions:

  • Exercise interventions for dialysis patients demonstrate high average recruitment, retention, and adherence rates.
  • A significant limitation is the inconsistent and often absent reporting of adherence rates across studies (only 27% reported).
  • Standardized reporting of recruitment, retention, and adherence metrics is essential for future research and clinical practice in ESKD exercise interventions.