Exercise is Medicine for Patients With CKD
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Renal Impairment / Chronic Kidney Disease |
| Therapuetic Areas: | Nephrology / Urology |
| Healthy: | No |
| Age Range: | 30 - 80 |
| Updated: | 4/6/2019 |
| Start Date: | April 16, 2018 |
| End Date: | March 2020 |
A Multi-center Exercise Intervention for Persons Transitioning to Dialysis Using the "Exercise is Medicine" Framework
The investigators plan to integrate and tailor the existing Exercise is Medicine framework,
an evidence-based multi-level intervention program developed by the American Society of
Sports Medicine, for the care of patients with advanced chronic kidney disease. In this pilot
randomized control trial, investigators will compare the effects and feasibility of two
intervention arms designed to start and maintain physical activity in this high-risk
population (Group 1: physical activity assessment, brief counseling session + physical
activity wearable versus Group 2: Group 1 intervention components + referral to a free,
community-based, EIM practitioner led group exercise program).
an evidence-based multi-level intervention program developed by the American Society of
Sports Medicine, for the care of patients with advanced chronic kidney disease. In this pilot
randomized control trial, investigators will compare the effects and feasibility of two
intervention arms designed to start and maintain physical activity in this high-risk
population (Group 1: physical activity assessment, brief counseling session + physical
activity wearable versus Group 2: Group 1 intervention components + referral to a free,
community-based, EIM practitioner led group exercise program).
Persons on dialysis are physically inactive, with most reporting activity levels below the
fifth percentile of healthy age-matched groups. Physical inactivity in turn increases the
risk for functional decline and mortality in this vulnerable population. The investigators
propose a pragmatic clinical trial for an exercise intervention among persons transitioning
to dialysis. The investigators will use an existing framework - Exercise is Medicine (EIM) -
developed by the American College of Sports Medicine. The investigators will randomize 98
persons from two regions—Atlanta and Bay Area—in two intervention arms with incremental
levels of clinical-community integration: physical activity assessment during Nephrology
clinical visit, brief counseling at pre-dialysis education and physical activity wearable
(group 1) versus group 1 intervention components plus a referral to a free, EIM
practitioner-led group exercise program over 16 weeks (group 2; 8 week core intervention; 8
week follow up). The investigators will assess efficacy by comparing between group
differences in minutes/week of (measured) moderate intensity physical activity. To evaluate
implementation, investigators will use questionnaires and exit interviews for assessing
barriers to referral, participation and retention along the path of the intervention;
investigators will use cost-utility analyses to assess scalability. Further the investigators
will have a plan for dissemination of the intervention by partnering with insurance providers
and both for-profit and non-profit dialysis organizations. The overall goal is to inform the
development of a practical, cost-conscious intervention that addresses barriers to physical
activity commonly faced by persons on dialysis, and can be delivered as a "package" to
interested practices.
fifth percentile of healthy age-matched groups. Physical inactivity in turn increases the
risk for functional decline and mortality in this vulnerable population. The investigators
propose a pragmatic clinical trial for an exercise intervention among persons transitioning
to dialysis. The investigators will use an existing framework - Exercise is Medicine (EIM) -
developed by the American College of Sports Medicine. The investigators will randomize 98
persons from two regions—Atlanta and Bay Area—in two intervention arms with incremental
levels of clinical-community integration: physical activity assessment during Nephrology
clinical visit, brief counseling at pre-dialysis education and physical activity wearable
(group 1) versus group 1 intervention components plus a referral to a free, EIM
practitioner-led group exercise program over 16 weeks (group 2; 8 week core intervention; 8
week follow up). The investigators will assess efficacy by comparing between group
differences in minutes/week of (measured) moderate intensity physical activity. To evaluate
implementation, investigators will use questionnaires and exit interviews for assessing
barriers to referral, participation and retention along the path of the intervention;
investigators will use cost-utility analyses to assess scalability. Further the investigators
will have a plan for dissemination of the intervention by partnering with insurance providers
and both for-profit and non-profit dialysis organizations. The overall goal is to inform the
development of a practical, cost-conscious intervention that addresses barriers to physical
activity commonly faced by persons on dialysis, and can be delivered as a "package" to
interested practices.
Inclusion Criteria:
- - eGFR < 30 ml/min/1.73m2
- Age ≥30 and ≤80 years
- Noncompliance with physical activity guidelines
- Not in precontemplation stage
- Non-wheelchair bound
- Able to provide informed consent in English or Spanish
- Anticipated to be living in the area over the next 36 weeks
Exclusion Criteria:
- - Inability to provide consent in English
- Diagnosed mental health disorder
- Alcohol or drug abuse
- No fixed address or contact details
- Unstable angina or unstable arrhythmias
- Lack of access to internet
- Any concern not otherwise stated by patient's nephrologist
We found this trial at
2
sites
Emory University Emory University, recognized internationally for its outstanding liberal artscolleges, graduate and professional schools,...
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