Exercise training in CKD: efficacy, adherence, and safety

Howden, Erin J., Coombes, Jeff S., Strand, Haakan, Douglas, Bettina, Campbell, Katrina L. and Isbel, Nicole M. (2015) Exercise training in CKD: efficacy, adherence, and safety. American Journal of Kidney Diseases, 65 4: 583-591. doi:10.1053/j.ajkd.2014.09.017

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads

Author Howden, Erin J.
Coombes, Jeff S.
Strand, Haakan
Douglas, Bettina
Campbell, Katrina L.
Isbel, Nicole M.
Title Exercise training in CKD: efficacy, adherence, and safety
Journal name American Journal of Kidney Diseases   Check publisher's open access policy
ISSN 1523-6838
Publication date 2015-04
Year available 2014
Sub-type Article (original research)
DOI 10.1053/j.ajkd.2014.09.017
Open Access Status
Volume 65
Issue 4
Start page 583
End page 591
Total pages 9
Place of publication Maryland Heights, MO, United States
Publisher W.B. Saunders
Collection year 2015
Language eng
Formatted abstract
Background: Exercise training increasingly is recommended as an important part of the management of cardiovascular disease. However, few studies have evaluated the effectiveness of exercise training in patients with chronic kidney disease (CKD), and those that have included very selective populations.

Study Design: Analysis of secondary outcomes of a randomized controlled trial, with participants randomly assigned to either lifestyle intervention or usual care (control).

Setting & Participants: Patients with CKD stages 3 to 4 and one or more uncontrolled cardiovascular risk factor were recruited from an outpatient clinic at a large tertiary hospital.

Intervention: Lifestyle intervention included access to multidisciplinary care through a nurse practitioner–led CKD clinic, exercise training, and a lifestyle program. The exercise training was a 2-phased program in which participants received 8 weeks of supervised training before commencing 10 months of home-based training.

Outcomes & Measurements: Efficacy, as assessed by metabolic equivalent tasks (METs), 6-minute walk distance, Timed Get-Up-and-Go test, grip strength, and anthropomorphic measures; adherence, as assessed by self-reported physical activity; and safety, as assessed by reported serious adverse events, were recorded.

Results: 83 patients were randomly assigned and 72 patients completed follow-up testing (intervention, n = 36; control, n = 36). The intervention resulted in a significant improvement in METs (pre, 7.2 ± 3.3; post, 9.7 ± 3.6), 6-minute walk distance (pre, 485 ± 110 m; post, 539 ± 82 m), and body mass index (pre, 32.5 ± 6.7 kg/m2; post, 31.9 ± 7.3 kg/m2). Reported physical activity levels significantly increased in the intervention group at 6 months, but decreased at 12 months. There were no serious adverse events related to the exercise training.

Limitations: This study was not powered to evaluate the safety of exercise training on serious adverse events.

Conclusions: The findings from the present study suggest that an exercise program that includes a supervised and home-based training phase is effective, adhered to, and safe in patients with CKD.
Keyword Physical activity
Exercise capacity
Physical functioning
Muscle strength
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 9 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 16 Dec 2014, 08:20:58 EST by Dr Haakan Strand on behalf of School of Nursing, Midwifery and Social Work