Structured exercise may help improve activity in older adults awaiting kidney transplant
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Key takeaways:
- Patients and care partners shared a lack of guidance on exercise regimen.
- Facilitators included enthusiasm to regain independence or functionality.
Certain facilitators may allow older patients to activity while awaiting a kidney transplant, despite patients and care partners reporting barriers to pretransplant exercise, data show.
“Targeted exercise interventions before transplantation have the potential to improve physical function and activity in waitlisted older patients and help maximize their benefit from transplantation,” Anoop Sheshadri, MD, MAS, of the departments of medicine at the University of California San Francisco and the San Francisco VA Health Care System, wrote with colleagues. Still, “only a small percentage of patients treated with dialysis (who make up the majority of patients awaiting kidney transplantation) are able to participate.”
Researchers conducted individual, in-depth, cognitive interviews with 23 patients aged 50 years and oldertreated with dialysis at the University of San Francisco kidney transplantation clinic. Interviews were done separately for patients and care partners.
The 60- to 90-minute semi-structured interviews were based on previous literature and input from geriatrics, nephrology and transplantation. Topics included general waitlist experience, quality of life, functional status and physical and symptoms among other topics.
Patients had a short physical performance of 10 or lower. Median patient age was 60 years and median care partner age was 57 years. Overall, 39% of patients and 78% of care partners were ; 39% of patients and 30% of care partners self-identified as Black.
Findings showed major themes for barriers to pretransplant exercise. Patients and care partners shared a lack of guidance on an exercise regimen, physical and/or cognitive impairments, difficulty scheduling exercise around dialysis treatments and motivation.
Facilitators, meanwhile, included social support for patients and care partners, enthusiasm to regain independence or functionality, as well as to promote successful transplantation.
“Older patients treated with dialysis and awaiting kidney transplantation reported significant barriers toward exercise in the pretransplant period, as did their care partners,” Sheshadri and colleagues wrote. “However, participants remained highly motivated to pursue exercise and offered many potential facilitators for future interventions.”
For example, researchers underlined an individualized exercise approach.
“Intervention that include an individualized and structured program of exercise may allow for improvement of physical function and quality of life for both patient and care partner. Further research is needed to determine specifics including modality and frequency,” they wrote.
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