Protocolized exercise improves frailty parameters and lower extremity impairment: A promising prehabilitation strategy for kidney transplant candidates
Background Frailty and decreased functional status are risk factors for adverse kidney transplant (KT) outcomes. Our objective was to examine the efficacy of an exercise intervention on frailty and decreased functional status in a cohort of patients with advanced chronic kidney disease (CKD). Method...
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| Published in: | Clinical transplantation Vol. 34; no. 9; pp. e14017 - n/a |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Denmark
01-09-2020
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| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background
Frailty and decreased functional status are risk factors for adverse kidney transplant (KT) outcomes. Our objective was to examine the efficacy of an exercise intervention on frailty and decreased functional status in a cohort of patients with advanced chronic kidney disease (CKD).
Methods
We conducted a prospective study involving 21 adults with ≥stage 4 CKD who were (a) frail or pre‐frail by Fried phenotype and/or (b) had lower extremity impairment [short physical performance battery score ≤10]. The intervention consisted of two supervised outpatient exercise sessions per week for 8 weeks.
Results
Among our cohort, median participant age was 62 years (interquartile range, 53‐67) and 85.7% had been evaluated for KT. Following the study, participants reported satisfaction with the intervention and multiple frailty parameters improved significantly, including fatigue, physical activity, walking time, and grip strength. Lower extremity impairment also improved (90.5%‐61.9%, P = .03). No study‐related adverse events occurred.
Conclusions
Preliminary data from this study suggest that a supervised, outpatient exercise intervention is safe, acceptable, feasible, and associated with improved frailty parameters, and lower extremity function, in patients with advanced CKD. Further studies are needed to confirm these findings and determine whether this prehabilitation strategy improves KT outcomes. |
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| Bibliography: | Clinical Trial NCT03535584 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Heidi A. Walker: participated in the performance of the research Hatem Amer: participated in writing of the paper Cassie C. Kennedy: participated in research design, writing of the paper, data analysis Karin L. Thompson: participated in the performance of the research and data analysis James K. Garrett: participated in the performance of the research and writing of the paper Elizabeth C. Lorenz: participated in research design, writing of the paper, data analysis Renee M. Weatherly: participated in the performance of the research and data analysis Judy M. Rasmussen: participated in the performance of the research LaTonya J. Hickson: participated in research design and writing of the paper Tara L. Stewart: participated in the performance of the research AUTHOR CONTRIBUTIONS |
| ISSN: | 0902-0063 1399-0012 |
| DOI: | 10.1111/ctr.14017 |