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The Effect of Chronic Kidney Disease on a Physical Activity Intervention: Impact on Physical Function, Adherence, and Safety.

ABSTRACT: Background:Because chronic kidney disease (CKD) is associated with muscle wasting, older adults with CKD are likely to have physical function deficits. Physical activity can improve these deficits, but whether CKD attenuates the benefits is unknown. Our objective was to determine if CKD modified the effect of a physical activity intervention in older adults. Methods:This is an exploratory analysis of the LIFE-P study, which compared a 12-month physical activity program (PA) to a successful aging education program (SA) in older adults. CKD was defined as a baseline eGFR < 60 mL/min/1.73 m2. We examined the Short Physical Performance Battery (SPPB) at baseline, 6 and 12 months. Secondary outcomes included serious adverse events (SAE) and adherence to intervention frequency. Linear mixed models were adjusted for age, sex, diabetes, hypertension, CKD, intervention, site, visit, baseline SPPB, and interactions of intervention and visit and of intervention, visit, and baseline CKD. Results:The sample included 368 participants. CKD was present in 105 (28.5%) participants with a mean eGFR of 49.2 ± 8.1 mL/min/1.73 m2. Mean SPPB was 7.38 ± 1.41 in CKD participants; 7.59 ± 1.44 in those without CKD (p = 0.20). For CKD participants in PA, 12-month SPPBs increased to 8.90 (95% CI 8.32, 9.47), while PA participants without CKD increased to 8.40 (95% CI 8.01, 8.79, p = 0.43). For CKD participants in SA, 12-month SPPBs increased to 7.67 (95% CI 7.07, 8.27), while participants without CKD increased to 8.12 (95% CI 7.72, 8.52, p = 0.86). Interaction between CKD and intervention was non-significant (p = 0.88). Number and type of SAEs were not different between CKD and non-CKD participants (all p > 0.05). In PA, adherence for CKD participants was 65.5 ± 25.4%, while for those without CKD was 74.0 ± 22.2% (p = 0.12). Conclusion:Despite lower adherence, older adults with CKD likely derive clinically meaningful benefits from physical activity with no apparent impact on safety, compared to those without CKD.

SUBMITTER: Liu CK

PROVIDER: S-EPMC5937279 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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The Effect of Chronic Kidney Disease on a Physical Activity Intervention: Impact on Physical Function, Adherence, and Safety.

Liu C K CK Milton J J Hsu F-C FC Beavers K M KM Yank V V Church T T Shegog J D JD Kashaf S S Nayfield S S Newman A A Stafford R S RS Nicklas B B Weiner D E DE Fielding R A RA

Journal of clinical nephrology and renal care 20170214 1

<h4>Background</h4>Because chronic kidney disease (CKD) is associated with muscle wasting, older adults with CKD are likely to have physical function deficits. Physical activity can improve these deficits, but whether CKD attenuates the benefits is unknown. Our objective was to determine if CKD modified the effect of a physical activity intervention in older adults.<h4>Methods</h4>This is an exploratory analysis of the LIFE-P study, which compared a 12-month physical activity program (PA) to a s ...[more]

PMID: 29745380

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Project description:BackgroundIndividuals with chronic kidney disease (CKD) have low levels of physical activity and physical function. Although guidelines endorse exercise counseling for individuals with CKD, it is not yet part of routine care.ObjectiveWe investigated the effect of attending a real-life exercise counseling clinic (ECC) on physical function in individuals with CKD.DesignRetrospective analysis of prospectively collected observational data with quasi-experimental design.Setting and participantsPatients with all stages of CKD registered in a large provincial renal program were eligible. The exposed cohort who attended the ECC between January 1, 2011, and March 15, 2014, included 214 individuals. The control cohort included 292 individuals enrolled in an observational study investigating longitudinal change in frailty during the same time period.Predictor/factorAttendance at an ECC.Outcomes and measurementsChange in physical function as measured by Short Physical Performance Battery (SPPB) score, physical activity level (Human Activity Profile [HAP]/Physical Activity Scale for the Elderly [PASE]), and health-related quality of life (HRQOL; EQ5D/VAS) over 1 year.ResultsEighty-seven individuals in the ECC cohort and 125 participants in the control cohort completed 1-year follow-up. Baseline median SPPB score was 10 (interquartile range [IQR]: 9-12) and 9 (IQR: 7-11) in the ECC and control cohorts, respectively (P < .01). At 1 year, SPPB scores were 10 (IQR: 8-12) and 9 (IQR: 6-11) in the ECC and control cohorts, respectively (P = .04). Mean change in SPPB over 1 year was not significantly different between groups: -0.33 (95% confidence interval [CI]: -0.81 to 0.15) in ECC and -0.22 (95% CI: -0.61 to 0.17) in control (P = .72). There was no significant difference in the proportion of individuals in each cohort with an increase/decrease in SPPB score over time. There was no significant change in physical activity or HRQOL over time between groups.LimitationsQuasi-experimental design, low rate of follow-up attendance.ConclusionsIn this pragmatic study, exercise counseling had no significant effect on change in SPPB score, suggesting that a single exercise counseling session alone is inadequate to improve physical function in CKD.

Project description:Background/objectivesTo examine the association between indices of sleep quantity and quality with dietary adherence, physical activity adherence, and weight loss during a behavioral weight loss intervention.MethodsAdults (n = 156) with overweight and obesity (40 ± 9 years, 84% female, BMI: 34.4 ± 4.2 kg/m2) participated in an 18-month behavioral weight loss intervention which prescribed a reduced calorie diet (1200-1800 kcal/d) and increased physical activity (300 min/wk). Body weight, indices of sleep (SenseWear armband; SWA), energy intake (EI, 3-day food records), and moderate-to-vigorous physical activity (SWA) were measured at baseline, 6, 12, and 18 months. Linear mixed effects models examined the association between sleep and weight change over time. Additional models were adjusted for covariates including age, BMI, sex, race, ethnicity, study completion, randomization, EI, and physical activity. Secondary analyses examined the association between sleep and adherence to diet and physical activity recommendations.ResultsMean weight loss was 7.7 ± 5.4, 8.4 ± 7.9, and 7.1 ± 9.0 kg at 6, 12, and 18 months, respectively. Lower sleep efficiency, higher wake after sleep onset (WASO), more awakenings, and higher sleep onset latency (SOL) were significantly associated with attenuated weight loss (p < 0.05). Lower sleep efficiency, more awakenings, and higher SOL remained significantly associated with blunted weight loss after adjustment for covariates (p < 0.05). Later waketime, longer time in bed, longer sleep duration, higher WASO, more awakenings, and higher SOL were associated with lower odds of achieving ≥300 min/wk of moderate-to-vigorous physical activity, adjusted for covariates (FDR p < 0.05).ConclusionsFuture studies should evaluate whether incorporating strategies to improve sleep health within a behavioral weight loss intervention leads to improved adherence to diet and physical activity recommendations and enhanced weight loss.Clinical trials identifierNCT01985568.

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The Effect of Chronic Kidney Disease on a Physical Activity Intervention: Impact on Physical Function, Adherence, and Safety.

Publications

The Effect of Chronic Kidney Disease on a Physical Activity Intervention: Impact on Physical Function, Adherence, and Safety.

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