The Impact of a Wearable Activity Tracker and Structured Feedback Program on Physical Activity in Hemodialysis Patients: The Step4Life Pilot Randomized Controlled Trial

Malhotra, Rakesh; Rahimi, Sina; Agarwal, Ushma K; Katz, Ronit; Kumar, Ujjala; Garimella, Pranav S.; Gupta, Vineet; Chopra, Tushar; Kotanko, Peter; İkizler, T. Alp; Larsen, Britta; Cadmus-Bertram, Lisa; Ix, Joachim H.

doi:10.1053/j.ajkd.2022.12.011

Cited by 6 publications

(11 citation statements)

References 21 publications

(31 reference statements)

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“…Characteristics of the included studies are presented in Table 2 . Three studies were performed in USA [ 23 , 24 , 26 ] and one each in UK [ 25 ] and Japan [ 27 ]. Four studies were conducted in outpatient hemodialysis centres [ 23 – 25 , 27 ] and one in a hospital-based nephrology unit [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Reported sample sizes ranged from 51 to 96 participants per study with a follow-up period of 3 to 35 months. Three studies [ 23 , 24 , 27 ] utilised patient reports to obtain falls data while one study [ 25 ] used medical records and hospital episode statistics and the process was not described clearly in one study [ 26 ]. Most of the studies were excluded because they did not specify the intervention or report the number or rate of falls, rather they reported risk factors of falls among dialysis patients ( n = 17).…”

Section: Resultsmentioning

confidence: 99%

“…Routine use of towels around dialysis machines to wick leaked fluid 7. Installation of support bars in patient restroom Period before the interventions (4-year baseline period) Incidence of falls that occurred at dialysis center’s premises Results: There were 2 patient-related falls in the postintervention period, a reduction in fall incidence to 9 (95% CI 0 to 21) falls per 100,000 dialysis treatments ( P = 0.06) Follow up: 21 months Drop outs: ND Sample size analysed: ND Moderate b Malhotra et al, 2023 [ 24 ]. Randomised controlled trial conducted at single academic outpatient HD facility in the USA N = 55 Male IG-15 CG-13 Female IG-13 CG-14 Participants with ESKD receiving hemodialysis who were able to walk with or without assistive devices The wearable activity tracker plus structured feedback (intervention) arm.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Three studies [ 24 , 25 , 27 ] utilised exercises as an intervention to prevent falls. The first study [ 24 ] used a wearable activity tracker plus structured feedback for patients in the intervention arm. Patients received face-to-face goal setting counseling in the dialysis facility along with feedback graphs and charts to visualise their progress.…”

Section: Resultsmentioning

confidence: 99%

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Interventions to reduce falls among dialysis patients: a systematic review

Gute,

Zimbudzi

2023

BMC Nephrol

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Introduction Despite all available evidence regarding increased morbidity and mortality among dialysis patients due to falls and their complications, and an increase in risk factors for falls, relatively little attention has been focused on evidence-based interventions that can reduce falls. We evaluated the effectiveness of fall prevention interventions among dialysis patients. Methods We searched Ovid-Medline, Ovid-Embase, PubMed, Cumulated Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trials (Central) from inception to 19 July 2023 for studies that evaluated the effectiveness of fall prevention interventions among dialysis patients. The search, screening and extraction of data followed standardised processes and the methodological quality of studies was independently assessed by two reviewers. Data was analysed using a narrative synthesis approach. Results Of the 18 studies that had full text review, five were eligible. Three studies were performed in the USA and one each in UK and Japan. Four studies were conducted in outpatient hemodialysis centres and one in a hospital-based nephrology unit. Reported sample sizes ranged from 51 to 96 participants per study with a follow-up period of 3 to 35 months. There was moderate-quality evidence that exercises reduce the rate of falls compared to usual care and low to moderate quality of evidence that multifactorial falls prevention interventions reduce the rate of falls. However, treatment effects could not be quantitatively estimated for all interventions due to substantial heterogeneity of included studies. Conclusions This systematic review reflects that there is insufficient evidence regarding falls prevention strategies specific to dialysis patients. Available data based on low to moderate quality studies, suggest that among dialysis patients, exercises may reduce falls and the effectiveness of multifactorial interventions such as staff and patient education still need to be explored using high-quality prospective studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%