Exercise and physical activity for people receiving peritoneal dialysis: Why not?

Isnard-Rouchon, Myriam; West, Mike; Bennett, Paul N.

doi:10.1111/sdi.12784

Cited by 28 publications

(45 citation statements)

References 27 publications

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“…The two specific PD questions revealed that the vast majority of patients did not feel their catheter or fluid in their peritoneum affected their ability to exercise. The finding that in the minds of the patients the PD catheter and PD fluid are not a barrier to activity is highly encouraging, as these have been previously reported as potential barriers to exercise (Isnard‐Rouchon et al 2019). The finding may also be a result of all respondents receiving APD, which reflected our service where 94% of patients receive APD and only 6% receive continuous ambulatory PD.…”

Section: Discussionmentioning

confidence: 76%

“…Given the positive perceptions towards exercise the questions arises “What are peritoneal dialysis providers doing to promote physical activity and exercise?” Given the lack of knowledge and evidence regarding what exercise is right for PD patients, the involvement of exercise professionals may be the answer (Isnard‐Rouchon et al 2019; Uchiyama et al 2019). Exercise professionals such as exercise physiologists, physical therapists, kinesiologists and athletic trainers, can provide exercise assessments, programmes and goal setting agreements with patients.…”

Section: Discussionmentioning

confidence: 99%

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The Exercise Perceptions of People Treated with Peritoneal Dialysis

Zeng

Bennett

Hill

et al. 2020

Journal of Renal Care

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SUMMARY Background Individuals receiving peritoneal dialysis (PD) report low levels of physical activity, which increases their risk of morbidity and mortality. Little is known about their perceptions towards barriers and benefits of exercise or physical activity. Aim The aim of this study was to explore the perceptions of exercise among people receiving PD. Study Design Cross‐sectional survey. Participants Thirty‐nine adults (12 female and 27 male) with a mean age of 65 years and a median of 8 months receiving PD from one Australian dialysis service. Measurements The 26‐item Dialysis Patient‐Perceived Exercise Benefits and Barriers Survey was adapted to PD in order to measure self‐reported barriers and benefits of exercise for people being treated with PD. Results The majority of the respondents reported positive perceptions towards exercise with 84.6% of the participants agreeing that exercise prevents muscular wasting; 71.8% agreed that exercise can postpone a decline in body function; and 69.2% agreed that exercise improves general well‐being. In terms of barriers, symptoms including tiredness (69.2%) and body pain (43.6%), worrying about a fall (33.3%) and lack of exercise‐related information (25.6%) were the main perceived barriers to exercise. Only 10% agreed that exercise may affect their PD catheter with 23% agreeing that fluid in their peritoneum was a barrier to exercise. Conclusion People on PD hold positive perceptions towards exercise but face a number of perceived barriers to physical activity. Clinicians can acknowledge these barriers and focus on helping people on PD to overcome their perceived barriers to encourage sustained exercise participation.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

The Exercise Perceptions of People Treated with Peritoneal Dialysis

Zeng

Bennett

Hill

et al. 2020

Journal of Renal Care

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“…Examples of exercise programs for PD patients have been reported in China, 18 , 19 France, 12 and Japan, 20 with no sustained exercise programs in the United States being reported in the past 20 years. 21 Exercise in PD research studies are also scarce, consisting mainly of smaller studies and heterogeneous outcomes 21 , 22 with no large interventional PD exercise (PDEx) studies reported in the United States.…”

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confidence: 99%

An Exercise Program for Peritoneal Dialysis Patients in the United States: A Feasibility Study

et al. 2020

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Background People with end-stage kidney disease receiving peritoneal dialysis (PD) are generally physically inactive and frail. Exercise studies in PD are scarce and currently there are no PD exercise programs in the United States. The primary objective of this study was to test the feasibility of a combined resistance and cardiovascular exercise program for PD patients under the care of a dedicated home dialysis center in the United States. Study Design Parallel randomized controlled feasibility study. Setting & Participants PD patients were recruited from a single center and randomly assigned to the intervention (exercise; n = 18) or control (nonexercise; n = 18) group. Intervention The intervention group received monthly exercise physiologist consultation, exercise prescription (resistance and aerobic exercise program using exercise bands), and 4 exercise support telephone calls over 12 weeks. The control group received standard care. Outcomes The primary outcome was study feasibility as measured by eligibility rates, recruitment rates, retention rates, adherence rates, adverse events, and sustained exercise rates. Secondary outcome measures were changes in physical function (sit-to-stand test, timed-up-and-go test, and pinch-strength tests) and patient-reported outcome measures. Results From a single center with 75 PD patients, 57 (76%) were deemed eligible, resulting in a recruitment rate of 36 (63%) patients. Participants were randomly assigned into 2 groups of 18 (1:1). 10 patients discontinued the study (5 in each arm), resulting in 26 (72%) patients, 13 in each arm, completing the study. 10 of 13 (77%) intervention patients were adherent to the exercise program. A t test analysis of covariance found a difference between the treatment groups for the timed-up-and-go test ( P = 0.04) and appetite ( P = 0.04). No serious adverse events caused by the exercise program were reported. Limitations Single center, no blinded assessors. Conclusions A resistance and cardiovascular exercise program appears feasible and safe for PD patients. We recommend that providers of PD therapy consider including exercise programs coordinated by exercise professionals to reduce the physical deterioration of PD patients. Funding None. Trial Registration NCT03980795 .

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“…Although some studies report that increased physical activity (PA) levels in patients with PD can generate benefits in controlling increased cardiovascular morbidity, mortality and loss of function, the effects of PA in patients on PD remain doubtful [9]. Recently practitioners have suggested that PD patients should increase their PA levels, as this increase allows patients to improve their quality of life and to reduce the adverse effects of inactivity [10].…”

Section: Introductionmentioning

confidence: 99%

High Levels of Physical Activity May Promote a Reduction in Bone Mineral Density in Peritoneal Dialysis

et al. 2020

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Background and objectives: Peritoneal dialysis (PD) patients are expected to present lower levels of physical activity, unhealthy changes at the body composition level, and low levels of strength. Firstly, this study aimed to report the sex differences in physical activity, body composition and muscle strength and the relations among these variables. Secondly, we analyze the relationship between physical activity and biochemical parameters. Materials and Methods: Thirty-four patients (13 women and 21 men) participated in this study. Body composition was assessed by bioimpedance and dual-energy X-ray absorptiometry (DXA), and maximum isokinetic unilateral strength, analytical parameters and physical activity levels were evaluated. Results: The men showed higher values for weight, height, lean body mass, bone mineral content, bone mineral density (BMD) and total body water, while women showed higher values for the percentage of fat mass and hydration of lean body mass (p < 0.05). No differences between the sexes were found in different levels of physical activity; however, males registered significantly higher values for isokinetic strength variables except for knee extensor strength. BMD was positively related to sedentary activity and negatively related to moderate and vigorous activity (r = 0.383 and r = −0.404, respectively). Light physical activity was negatively correlated with albumin (r = −0.393) and total protein (r = −0.410) levels, while moderate/vigorous activity was positively correlated with urea distribution volume (r = 0.446) and creatinine clearance (r = 0.359) and negatively correlated with the triglyceride level (r = −0.455). Conclusions: PD patients with higher levels of physical activity present better results in terms of body composition and biochemical parameters. Additional studies should be conducted to clarify the relation between physical activity level and BMD.

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Exercise and physical activity for people receiving peritoneal dialysis: Why not?

Cited by 28 publications

References 27 publications

The Exercise Perceptions of People Treated with Peritoneal Dialysis

The Exercise Perceptions of People Treated with Peritoneal Dialysis

An Exercise Program for Peritoneal Dialysis Patients in the United States: A Feasibility Study

High Levels of Physical Activity May Promote a Reduction in Bone Mineral Density in Peritoneal Dialysis

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