m-Health-based exercise program among children and adolescents with chronic kidney disease: a feasibility study

Children and adolescents with chronic kidney disease (CKD) often exhibit reduced physical fitness due to physical inactivity, fatigue, and muscle weakness. Despite the exercise benefits, participation remains limited due to barriers such as limited access, inadequate resources, and poor motivation. The m-Health platform may provide an adaptable strategy to address these challenges. Hence, this study aimed to assess the feasibility of the m-Health-based exercise program among the pediatric CKD population.

Thirty children and adolescents with CKD stages 3-5, aged 6-18 years, were enrolled in a 4-week m-Health-based exercise program. Feasibility was evaluated through adherence, usability, satisfaction, and semi-structured telephonic interviews with participants and caregivers. Functional outcomes included the 6-min walk test (6-MWT) and hand grip strength (HGS). Adherence, usability, and satisfaction data were summarized using descriptive statistics. Thematic analysis was used to represent the qualitative data. Pre- and post-intervention 6-MWT and HGS values were compared using paired t-tests.

Twenty-seven participants completed the study. Adherence to the m-Health exercise program was low, with 18.5% meeting the criteria. However, 51.8% reported excellent usability, and satisfaction was reported by 70.3% of parents and 62.9% of participants. Qualitative data highlighted three key aspects-alternative exercise practices, perceived exercise benefits, and multifaceted barriers. Participants demonstrated significant improvements in their functional outcomes post-intervention (6-MWT, 48.8 m, p < 0.001; HGS, 0.7 kg, p = 0.021).

Despite low adherence, the m-Health-based exercise program served as a motivating stimulus for promoting physical activity and facilitating positive behavior change among children and adolescents with CKD.

This study was registered with the Clinical Trials Registry of India (CTRI) on 20-11-2024 under registration number CTRI/2024/11/077131.