ABSTRACT
This article reviews the literature addressing exercise programs for dialysis patients to identify elements necessary for sustaining exercise programs in this population. Literature searches for publications (January 1980-February 2009) in Medline (OVID), PubMed, CINAHL (EBSCO), EBSCOhost EJS, ProQuest Central, Web of Science, Cochrane Library, Google Scholar, ScienceDirect, SpringerLink (Kluwer), and Wiley Interscience (Blackwell) were performed. Reference lists from relevant articles were hand-searched for further publications. Criteria for inclusion included full-text primary research and review articles focused on exercise for adult hemodialysis patients. One hundred and seventy one publications were found with a primary focus on exercise in hemodialysis. Of these, 28 primary research and 14 review articles addressed one or more aspects of sustainability of hemodialysis exercise programs. Factors contributing to sustainable exercise programs included: dedicated exercise professionals; encouragement to exercise intradialytically; dialysis and medical staff commitment; adequate physical requirements of equipment and space; interesting and stimulating; cost implications need to be addressed; exercise is not for everyone; requires individual prescription; and there is no age barrier to exercise on hemodialysis.
Subject(s)
Exercise Therapy , Renal Dialysis , HumansABSTRACT
AIM: This study explored whether an exercise programme for haemodialysis patients, including the use of a purpose built dialysis exercise machine, would improve quality of life (QoL), nutrition, physical function and biochemical indices. METHODS: Intervention was a 6 month individualised exercise programme, which was continued up to 12 months. QoL, and biochemical indices were measured at 6 months and nutrition was measured at 12 months. Physical function was measured at 4, 8 and 12 months. RESULTS: N=22. Improvement in physical function tests was found for the sit to stand (p = 0.005), step in place (p = 0.005) and arm curl (p = 0.05) tests from baseline to 4 months. We showed a decreased in serum phosphate (0.19 mmol/L p = 0.008), no change in other nutritional parameters and an increase in urea reduction ratio (1.6% p = 0.019) in the exercising group. The QoL health and physical functioning domain improved with increased significance (+3.5 p = 0.055). CONCLUSIONS: The development of a structured exercise programme can improve quality of life, physical functioning, PO4 levels and urea clearances of dialysis patients.
Subject(s)
Exercise Therapy/organization & administration , Kidney Failure, Chronic/rehabilitation , Renal Dialysis , Activities of Daily Living/psychology , Aged , Blood Urea Nitrogen , Equipment Design , Exercise Therapy/instrumentation , Feasibility Studies , Female , Health Status , Humans , Kidney Failure, Chronic/metabolism , Kidney Failure, Chronic/psychology , Male , Middle Aged , Nursing Assessment , Nursing Evaluation Research , Nutrition Assessment , Nutritional Status , Phosphates/blood , Physical Endurance , Pilot Projects , Quality of Life/psychology , Renal Dialysis/nursing , Renal Dialysis/psychology , Surveys and Questionnaires , Treatment OutcomeABSTRACT
OBJECTIVE: To assess the reliability of a nurse-performed nutrition screening tool (NST) for hemodialysis (HD) patients to identify nutritionally at-risk patients. DESIGN: Tool reliability assessment. SETTING AND PARTICIPANTS: The setting was nine non-hospital private (n = 3) and public (n = 6) HD units in Australia (two rural and seven metropolitan). Participants were 112 HD patients. RESULTS: A total of 112 HD patients (male = 65, female = 47) from 9 non-hospital HD units in Australia (seven metropolitan and two rural) were screened with the NST and the outcome of dietitian referral compared with Standard Dietitians Assessment. The mean age of patients was 57.6 years. Overall, the NST showed a sensitivity of 0.84 (range, 0.71 to 0.94; P < .05) and a specificity of 0.9 (range, 0.82 to 0.98; P < .05). The NST was more sensitive (sensitivity, 0.93 [range, 0.87 to 0.99; P < .05]) and was more specific for men (specificity, 0.92 [range, 0.85 to 0.99; P < .05]). Specificity was very strong in metropolitan patients (specificity, 0.94 [range, 0.87 to 1.01; P < .05]). CONCLUSIONS: The tool was more sensitive and specific than the NST previously reported by the same investigators. The tool is particularly specific in that it screens those patients not requiring dietitian intervention. The use of this tool may benefit HD units that do not have on-site or regular dietetic support to prioritize patients needing dietitian intervention.
