Abstract: SA-PO879
Pedometers and Exercise in Dialysis
Session Information
- Dialysis: Cardiovascular, BP, Volume
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 701 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Sheshadri, Anoop, University of California, San Francisco, San Francisco, California, United States
- Kittiskulnam, Piyawan, Chulalongkorn university, Bangkok, Thailand
- Johansen, Kirsten L., University of California, San Franicsco, San Francisco, California, United States
Background
Dialysis patients report very low levels of physical activity. We conducted a study using a pedometer based intervention to investigate whether it would result in increased physical activity and whether increasing activity could improve physical and endothelial function, heart rate variability (HRV), and symptom severity.
Methods
We conducted a randomized controlled trial of 60 patients receiving HD or PD. Patients were given a pedometer and instructed to record steps for one week. Patients were then randomized to either standard of care or a 12-week intervention program during which they were asked to record steps and given weekly activity goals. At baseline, 12 weeks, and 24 weeks (3 months after the intervention), we assessed physical function (SF-36 Physical Function scores, Short Physical Performance Battery), endothelial function (reactive hyperemia index with peripheral arterial tonometry), HRV, and symptoms (Dialysis Symptoms Index [DSI], KDQOL Vitality score).
Results
At 3 months, patients in the intervention increased average daily step count by 2,060 (95% CI 80; 4,060) compared to controls, though physical function, endothelial function, HRV, and symptoms did not change significantly. However, patients reverted to baseline levels of activity 3 months after the intervention. In post-hoc analyses increases in step count were associated with decreases in symptom burden (-0.38 symptoms on DSI per 1,000 steps), symptom severity (-1.34 points on DSI score per 1,000 steps), fatigue (2.33 points on KDQOL Vitality score per 1,000 steps), and increased HRV (2.29 ms SDNN per 1,000 steps).
Conclusion
Dialysis patients can effectively use pedometers to increase physical activity but may need continued counselling in order to maintain increases. We found preliminary evidence that increasing step counts may also lead to improvements in symptoms and heart rate variability.
Funding
- NIDDK Support