Barriers and enablers to exercise in kidney transplant recipients: Systematic review of qualitative studies

• Published in: Journal of renal care Vol. 50; no. 4; pp. 384 - 404
• Main Authors: Bates, Alexander, Letton, Meg E., Arnold, Ria, Lambert, Kelly
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-12-2024
• Edition: English ed.
• Subjects: exercise; kidney transplant; Kidney transplants; qualitative; Systematic review; theoretical domains framework; kidney transplant; exercise; systematic review; theoretical domains framework; qualitative
• ISSN: 1755-6678; 1755-6686; 1755-6686
• DOI: 10.1111/jorc.12497

Background
Exercise has the potential to reduce the susceptibility to comorbidity and cardiovascular disease in kidney transplant recipients. However, kidney transplant recipients report lower levels of exercise compared to the general population, prompting an investigation into the barriers and enablers to exercise in this transplant cohort.
Objectives
This systematic review aimed to explore and map the barriers and enablers to exercise in kidney transplant recipients.
Methods
Seven electronic databases were systematically searched. Themes were synthesised and then deductively categorised using the Theoretical Domains Framework.
Results
Eleven studies were included in the review. Commonly reported barriers to exercise were lack of exercise guidance (n = 9 studies), physical limitations (n = 5 studies) and a fear of harming the kidney (n = 7 studies). Enablers were a desire to return to normality (n = 5 studies), physical and mental benefits (n = 3 studies), goal setting and tracking improvements (n = 3 studies). At the local level, barriers identified by kidney transplant recipients were a lack of knowledge, fear of injuring the kidney, bad weather and physical limitations. Perceived enablers were already living an active lifestyle, mental benefits, exercise preferences and social support.
Conclusion
Key findings of this research were an increased demand for specific/explicit exercise information regarding type and intensity, and personalised guidance and support for kidney transplant recipients after transplantation. These findings can be used to inform the development of exercise resources and interventions for kidney transplant recipients and their health care professionals within the local community and at a greater level.