Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial

BMC Geriatr. 2018 Oct 20;18(1):248. doi: 10.1186/s12877-018-0938-5.

Abstract

Background: Older adults dialysis patients represent the frailest subgroup of the End Stage Renal Disease (ESRD) population and physical exercise program may mitigate the age-related decline in muscle mass and function.

Methods: Dialysis patients of the EXCITE trial aged > 65 years (n = 115, active arm, n = 53; control arm, n = 62) were submitted in random order to a home based, low intensity physical exercise program. At baseline and 6 months after exercise training 6-min walking distance (6MWD) and 5-time sit-to-stand test (5STS) were performed, and quality of life (QoL) was tested.

Results: The training program improved both the 6MWD (6-months: 327 ± 86 m versus baseline: 294 ± 74 m; P < 0.001) and the 5STS time (6-months: 19.8 ± 5.6 s versus baseline: 22.5 ± 5.1 s; P < 0.001) in the exercise group whereas they did not change in the control group (P = 0.98 and 0.25, respectively). The between-arms differences (6 months-baseline) in the 6MWD (+ 34.0 m, 95% CI: 14.4 to 53.5 m) and in the 5STS time changes (- 1.9 s, 95% CI: -3.6 to - 0.3 s) were both statistically significant (P = 0.001 and P = 0.024, respectively). The cognitive function dimension of QoL significantly reduced in the control arm (P = 0.04) while it remained unchanged in the active arm (P = 0.78) (between groups difference P = 0.05). No patient died during the trial and the training program was well tolerated.

Conclusions: This secondary analysis of the EXCITE trial shows that a home-based, exercise program improves physical performance and is well tolerated in elderly ESRD patients.

Trial registration: The trial was registered in ClinicalTrials.Gov ( Clinicaltrials.gov identifier: NCT01255969) on December 8, 2010.

Keywords: Dialysis patients; Physical exercise; Quality of life.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Exercise / physiology*
  • Exercise / psychology
  • Exercise Therapy / methods*
  • Exercise Therapy / trends*
  • Female
  • Home Care Services / trends*
  • Humans
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Physical Therapy Modalities / trends
  • Quality of Life / psychology
  • Renal Dialysis / adverse effects
  • Renal Dialysis / psychology
  • Renal Dialysis / trends*

Associated data

  • ClinicalTrials.gov/NCT01255969