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Original ArticlesChronic Kidney Disease
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Effects of a Renal Rehabilitation Exercise Program in Patients with CKD: A Randomized, Controlled Trial

Ana P. Rossi, Debra D. Burris, F. Leslie Lucas, Gail A. Crocker and James C. Wasserman
CJASN December 2014, 9 (12) 2052-2058; DOI: https://doi.org/10.2215/CJN.11791113
Ana P. Rossi
*Department of Nephrology and Transplantation, Maine Medical Center,
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Debra D. Burris
†Clinical Trial Support Services, Maine Medical Center Research Institute,
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F. Leslie Lucas
‡Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, and
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Gail A. Crocker
§Turning Point Cardiac Rehabilitation & Prevention, Maine Medical Center, Portland, Maine
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James C. Wasserman
*Department of Nephrology and Transplantation, Maine Medical Center,
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Abstract

Background and objectives Patients with CKD have a high prevalence of cardiovascular disease associated with or exacerbated by inactivity. This randomized, controlled study investigated whether a renal rehabilitation exercise program for patients with stages 3 or 4 CKD would improve their physical function and quality of life.

Design, setting, participants, & measurements In total, 119 adults with CKD stages 3 and 4 were randomized, and 107 of these patients proceeded to usual care or the renal rehabilitation exercise intervention consisting of usual care plus guided exercise two times per week for 12 weeks (24 sessions). Physical function was determined by three well established performance-based tests: 6-minute walk test, sit-to-stand test, and gait-speed test. Health-related quality of life was assessed by the RAND 36-Item Short Form Health Survey.

Results At baseline, no differences in self-reported level of activity, 6-minute walk test, and sit-to-stand test scores were observed between the usual care (n=48) and renal rehabilitation exercise (n=59) groups, although baseline gait-speed test score was higher in the renal rehabilitation exercise group (P<0.001). At follow-up, the renal rehabilitation exercise group but not the usual care group showed significant improvements in the 6-minute walk test (+210.4±266.0 ft [19% improvement] versus −10±219.9 ft; P<0.001), the sit-to-stand test (+26.9±27% of age prediction [29% improvement] versus +0.7±12.1% of age prediction; P<0.001), and the RAND-36 physical measures of role functioning (P<0.01), physical functioning (P<0.01), energy/fatigue levels (P=0.01), and general health (P=0.03) and mental measure of pain scale (P=0.04). The renal rehabilitation exercise regimen was generally well tolerated.

Conclusions A 12-week/24-session renal rehabilitation exercise program improved physical capacity and quality of life in patients with CKD stages 3 and 4. Longer follow-up is needed to determine if these findings will translate into decreased mortality rates.

  • CKD
  • exercise training
  • physical function
  • quality of life
  • renal rehabilitation exercise
  • Received November 21, 2013.
  • Accepted August 25, 2014.
  • Copyright © 2014 by the American Society of Nephrology
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Clinical Journal of the American Society of Nephrology: 9 (12)
Clinical Journal of the American Society of Nephrology
Vol. 9, Issue 12
December 05, 2014
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Effects of a Renal Rehabilitation Exercise Program in Patients with CKD: A Randomized, Controlled Trial
Ana P. Rossi, Debra D. Burris, F. Leslie Lucas, Gail A. Crocker, James C. Wasserman
CJASN Dec 2014, 9 (12) 2052-2058; DOI: 10.2215/CJN.11791113

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Effects of a Renal Rehabilitation Exercise Program in Patients with CKD: A Randomized, Controlled Trial
Ana P. Rossi, Debra D. Burris, F. Leslie Lucas, Gail A. Crocker, James C. Wasserman
CJASN Dec 2014, 9 (12) 2052-2058; DOI: 10.2215/CJN.11791113
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Keywords

  • CKD
  • exercise training
  • physical function
  • quality of life
  • renal rehabilitation exercise

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