A physical activity intervention feasibility study for renal inpatients: a basic research protocol

Background: Low physical activity levels and poor physical functioning are strongly associated with poor clinical outcomes and mortality in adult End Stage Kidney Disease (ESKD) patients, regardless of treatment modality. Compared to the general population, individuals with chronic kidney disease are physically inactive, have reduced physical abilities and difficulties performing routine daily tasks, lower health-related quality of life, higher cardiovascular morbidity and mortality. In addition, frail ESKD patients have higher hospitalization and mortality rates than other ESKD patients. Evidence suggests that assessment and recommendations for physical activity should be part of standard care for ESKD patients. Structured exercise can improve physical function and quality of life in frail older adults and may be used specifically for management of frailty in ESKD. However, research is needed to determine best practices for implementation of physical function measurements and physical activity promotion in standard ESKD care. Objective: The proposed Move More study will assess the feasibility of a physical activity intervention offered to the ESKD inpatients in Calgary, Alberta. Specifically, this study is designed to examine the effects of an early physical activity/mobility intervention led by a kinesiologist (KT), and supported by the clinical care team including physiotherapists (PT) and nurse clinicians.Methods: The Move More study is a single-arm pilot intervention examining feasibility and preliminary efficacy. ESKD inpatients at the Foothills Medical Centre will be recruited to participate. Patients will receive an individualized in-hospital physical activity/mobility intervention. Frailty and physical function will be assessed at baseline and post-intervention prior to hospital discharge. Conclusions: Evidence needed to support the inclusion of mobility and physical activity as part of standard care will be gathered, with knowledge gained used to help direct future physical activity programming for ESKD inpatients.