Physical activity and exercise programs for kidney patients: an Italian survey of nephrology centres.
Barriers
Exercise training
Haemodialysis
Inactivity
Kidney transplant
Research
Journal
Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268
Informations de publication
Date de publication:
06 Mar 2024
06 Mar 2024
Historique:
received:
16
10
2023
accepted:
07
01
2024
medline:
6
3
2024
pubmed:
6
3
2024
entrez:
6
3
2024
Statut:
aheadofprint
Résumé
Data on exercise activities in place, and on the interest for developing them in Nephrology Services in Italy is limited. To address this gap, we carried out this cross-sectional study to investigate the status of physical activity and exercise programs available in Italian Nephrology Centres. Additionally, research priorities on this topic were examined. We developed a 14-item electronic survey, which consisted of multiple-choice questions covering exercise training programs, physical assessment, barriers to exercise practice and to exercise programs, exercise and physical activity counselling practices, perceived exercise benefits, literature evidence, and research priorities. Data on the characteristics of the centres were also collected. Sixty-two responses from Italian nephrology centres were collected. Ninety-three percent of the respondents were aware of the scientific evidence supporting the benefits of regular exercise programs for chronic kidney disease (CKD) patients. Additionally, in 75% of centres the nephrologists believed that physical activity counselling should be performed by the nephrologists. However, only 26% of centres provided exercise programs, mainly for dialysis patients, and 63% never or infrequently assessed physical activity in the context of patient management. Eighty-nine percent of centres reported barriers to implementing exercise programs, including lack of funding, institutional disinterest, patient refusal, and negative attitudes of the healthcare personnel. Forty-six research priorities related to exercise in CKD patients were suggested, with the majority focusing on impact of exercise programs and physical activity on cardiovascular, nutritional, and psychosocial outcomes. This survey highlights the limited availability of exercise programs and physical activity evaluation in clinical practice in Italian Nephrology Centres. However, the survey also revealed a strong interest for counselling CKD patients on physical activity and implementing exercise prescriptions and interventions.
Sections du résumé
BACKGROUND
BACKGROUND
Data on exercise activities in place, and on the interest for developing them in Nephrology Services in Italy is limited. To address this gap, we carried out this cross-sectional study to investigate the status of physical activity and exercise programs available in Italian Nephrology Centres. Additionally, research priorities on this topic were examined.
METHODS
METHODS
We developed a 14-item electronic survey, which consisted of multiple-choice questions covering exercise training programs, physical assessment, barriers to exercise practice and to exercise programs, exercise and physical activity counselling practices, perceived exercise benefits, literature evidence, and research priorities. Data on the characteristics of the centres were also collected.
RESULTS
RESULTS
Sixty-two responses from Italian nephrology centres were collected. Ninety-three percent of the respondents were aware of the scientific evidence supporting the benefits of regular exercise programs for chronic kidney disease (CKD) patients. Additionally, in 75% of centres the nephrologists believed that physical activity counselling should be performed by the nephrologists. However, only 26% of centres provided exercise programs, mainly for dialysis patients, and 63% never or infrequently assessed physical activity in the context of patient management. Eighty-nine percent of centres reported barriers to implementing exercise programs, including lack of funding, institutional disinterest, patient refusal, and negative attitudes of the healthcare personnel. Forty-six research priorities related to exercise in CKD patients were suggested, with the majority focusing on impact of exercise programs and physical activity on cardiovascular, nutritional, and psychosocial outcomes.
CONCLUSION
CONCLUSIONS
This survey highlights the limited availability of exercise programs and physical activity evaluation in clinical practice in Italian Nephrology Centres. However, the survey also revealed a strong interest for counselling CKD patients on physical activity and implementing exercise prescriptions and interventions.
Identifiants
pubmed: 38446385
doi: 10.1007/s40620-024-01896-w
pii: 10.1007/s40620-024-01896-w
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Marco Leoni
(M)
Massimo Manes
(M)
Lorena Traversari
(L)
Alessandra Collosi
(A)
Paolo Lentini
(P)
Antonino Previti
(A)
Valentina Fanny Leone
(VF)
Luigi Vernaglione
(L)
Giuseppe Leonardi
(G)
Alessandra Dalla Gassa
(A)
Michele Andreucci
(M)
Lorenzo Diliberato
(L)
Gemma Patella
(G)
Rosa Piperno
(R)
Mario Renato Rapanà
(MR)
Maria Angela Campolo
(MA)
Luca Piscitani
(L)
Giorgio Splendiani
(G)
Paolo Ria
(P)
Manuela Parrini
(M)
Mauro Dugo
(M)
Giuseppe Vezzoli
(G)
Monique Buskermolen
(M)
Gaetano Alfano
(G)
Laila Qassim
(L)
Maria Amicone
(M)
Ersilia Satta
(E)
Giancarlo Marinelli
(G)
Gabriele Guglielmetti
(G)
Carlo Massara
(C)
Giuseppe Scaparrotta
(G)
Leonardo Calandra
(L)
Massimiliano Tosto
(M)
Riccardo Maria Fagugli
(RM)
Federica Baciga
(F)
Roberto Scarpioni
(R)
Antonio Barilla
(A)
Elisa Giglio
(E)
Andrea Buscaroli
(A)
Francesca Mallamaci
(F)
Danio Somenzi
(D)
Antonio Favaro
(A)
Fulvio Fiorini
(F)
Alessandro Naticchia
(A)
Sandra Papalini
(S)
Veronica Baglio
(V)
Sandra La Rosa
(S)
Stefano Cenerelli
(S)
Marco Amidone
(M)
David Micarelli
(D)
Marco Pozzato
(M)
Fabrizio Valente
(F)
Monica Rizzolo
(M)
Francesco Bianco
(F)
Chiara Caletti
(C)
Antonietta Gazo
(A)
Paolo Albrizio
(P)
Informations de copyright
© 2024. The Author(s).
Références
Wilkinson TJ, Clarke AL, Nixon DGD, Hull KL, Song Y, Burton JO, Yates T, Smith AC (2021) Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study. Nephrol Dial Transplant 36(4):641–649
doi: 10.1093/ndt/gfz235
pubmed: 31725147
Bellizzi V, Cupisti A, Capitanini A, Calella P, D’Alessandro C (2014) Physical activity and renal transplantation. Kidney Blood Press Res 39(2–3):212–219
doi: 10.1159/000355799
pubmed: 25118089
Calella P, Hernández-Sánchez S, Garofalo C, Ruiz JR, Carrero JJ, Bellizzi V (2019) Exercise training in kidney transplant recipients: a systematic review. J Nephrol 32(4):567–579
doi: 10.1007/s40620-019-00583-5
pubmed: 30649716
Zelle DM, Klaassen G, van Adrichem E, Bakker SJ, Corpeleijn E, Navis G (2017) Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol 13(3):152-168.0
doi: 10.1038/nrneph.2016.187
pubmed: 28138130
Battaglia Y, Lamberti N, Piva G, Manfredini F, Storari A (2021) Physical exercise in chronic kidney disease: an empty narrative or an effective intervention? G Ital Nefrol 38(6):2021-vol6.Italian
Stevens PE, Levin A, Kidney Disease: Improving Global Outcomes Chronic Kidney Disease Guideline Development Work Group Members (2013) Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med 158(11):825–830
doi: 10.7326/0003-4819-158-11-201306040-00007
pubmed: 23732715
K/DOQI Workgroup (2005) K/DOQI clinical practice guidelines for cardiovascular disease in dialysis patients. Am J Kidney Dis 45(4 Suppl 3):S1-153
Baker LA, March DS, Wilkinson TJ, Billany RE, Bishop NC, Castle EM, Chilcot J, Davies MD, Graham-Brown MPM, Greenwood SA, Junglee NA, Kanavaki AM, Lightfoot CJ, Macdonald JH, Rossetti GMK, Smith AC, Burton JO (2022) Clinical practice guideline exercise and lifestyle in chronic kidney disease. BMC Nephrol 23(1):75
doi: 10.1186/s12882-021-02618-1
pubmed: 35193515
pmcid: 8862368
Taryana AA, Krishnasamy R, Bohm C et al (2019) Physical activity for people with chronic kidney disease: an international survey of nephrologist practice patterns and research priorities. BMJ Open 9:e032322
doi: 10.1136/bmjopen-2019-032322
pubmed: 31857307
pmcid: 6936996
Villanego F, Arroyo D, Martínez-Majolero V, Hernández-Sánchez S, Esteve-Simó V, en representación del Grupo Español Multidisciplinar de Ejercicio Físico en el Enfermo Renal (GEMEFER) (2023) Importance of physical exercise prescription in patients with chronic kidney disease: results of the survey of the Grupo Español Multidisciplinar de Ejercicio Físico en el Enfermo Renal [Spanish Multidisciplinary Group of Physical Exercise in Kidney Patients] (GEMEFER). Nefrologia (Engl Ed). 43(1):126–132
doi: 10.1016/j.nefroe.2023.03.009
pubmed: 37003930
Aucella F, Battaglia Y, Bellizzi V, Bolignano D, Capitanini A, Cupisti A (2015) Physical exercise programs in CKD: lights, shades and perspectives [corrected]. J Nephrol 28(2):143–150
doi: 10.1007/s40620-014-0169-6
pubmed: 25644550
Aucella F, Gesuete A, Battaglia Y (2014) A “nephrological” approach to physical activity. Kidney Blood Press Res 39(2–3):189–196
doi: 10.1159/000355796
pubmed: 25118037
Greenwood SA, Koufaki P, Rush R et al (2014) Exercise counselling practices for patients with chronic kidney disease in the UK: a renal multidisciplinary team perspective. Nephron Clin Pract 128:67–72
doi: 10.1159/000363453
pubmed: 25358965
Bennett PN, Kohzuki M, Bohm C, Roshanravan B, Bakker SJL, Viana JL, MacRae JM, Wilkinson TJ, Wilund KR, Van Craenenbroeck AH, Sakkas GK, Mustata S, Fowler K, McDonald J, Aleamañy GM, Anding K, Avin KG, Escobar GL, Gabrys I, Goth J, Isnard M, Jhamb M, Kim JC, Li JW, Lightfoot CJ, McAdams-DeMarco M, Manfredini F, Meade A, Molsted S, Parker K, Seguri-Orti E, Smith AC, Verdin N, Zheng J, Zimmerman D, Thompson S, Global Renal Exercise Network (GREX) (2022) Global policy barriers and enablers to exercise and physical activity in kidney care. J Ren Nutr 32(4):441–449
doi: 10.1053/j.jrn.2021.06.007
pubmed: 34393071
Clyne N, Anding-Rost K (2021) Exercise training in chronic kidney disease-effects, expectations and adherence. Clin Kidney J 14(2):3–14
doi: 10.1093/ckj/sfab012
Duijvestijn M, de Wit GA, van Gils PF, Wendel-Vos GCW (2023) Impact of physical activity on healthcare costs: a systematic review. BMC Health Serv Res 23(1):572
doi: 10.1186/s12913-023-09556-8
pubmed: 37268930
pmcid: 10239135
Mallamaci F et al (2020) Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial. Nephrology Dial Transplant 35(Supplement_2):ii18–ii22
doi: 10.1093/ndt/gfaa012
Regolisti G, Maggiore U, Sabatino A, Gandolfini I, Pioli S et al (2018) Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment. PLoS ONE 13(4):e0196313
doi: 10.1371/journal.pone.0196313
pubmed: 29702702
pmcid: 5922547
Manfredini F, Lamberti N, Battaglia Y, Straudi S, Belvederi Murri M, Donadi M, Piva G, Fabbian F, López-Soto PJ, Grassi L, Manfredini R, Basaglia N, Storari A (2020) A Personalized patient-centered intervention to empower through physical activity the patient in the dialysis center: study protocol for a pragmatic nonrandomized clinical trial. Methods Protoc 3(4):83
doi: 10.3390/mps3040083
pubmed: 33470990
pmcid: 7768449
Baggetta R, D’Arrigo G, Torino C, ElHafeez SA, Manfredini F, Mallamaci F, Zoccali C, Tripepi G, EXCITE Working group (2018) Effect of a home based, low intensity, physical exercise program in older adults dialysis patients: a secondary analysis of the EXCITE trial. BMC Geriatr 18(1):248
doi: 10.1186/s12877-018-0938-5
pubmed: 30342464
pmcid: 6196029
Manfredini F, Mallamaci F, D’Arrigo G, Baggetta R, Bolignano D, Torino C, Lamberti N, Bertoli S, Ciurlino D, Rocca-Rey L, Barillà A, Battaglia Y, Rapanà RM, Zuccalà A, Bonanno G, Fatuzzo P, Rapisarda F, Rastelli S, Fabrizi F, Messa P, De Paola L, Lombardi L, Cupisti A, Fuiano G, Lucisano G, Summaria C, Felisatti M, Pozzato E, Malagoni AM, Castellino P, Aucella F, Abd ElHafeez S, Provenzano PF, Tripepi G, Catizone L, Zoccali C (2017) Exercise in patients on dialysis: a multicenter, randomized clinical trial. J Am Soc Nephrol 28(4):1259–1268 (Epub 2016 Dec 1. Erratum in: J Am Soc Nephrol. 2018 Jul;29(7):2028)
doi: 10.1681/ASN.2016030378
pubmed: 27909047
Baggetta R, Bolignano D, Torino C, Manfredini F, Aucella F, Barillà A, Battaglia Y, Bertoli S, Bonanno G, Castellino P, Ciurlino D, Cupisti A, D’Arrigo G, De Paola L, Fabrizi F, Fatuzzo P, Fuiano G, Lombardi L, Lucisano G, Messa P, Rapanà R, Rapisarda F, Rastelli S, Rocca-Rey L, Summaria C, Zuccalà A, Abd ElHafeez S, Tripepi G, Catizone L, Mallamaci F, Zoccali C, EXCITE Working Group (2014) Fitness for entering a simple exercise program and mortality: a study corollary to the exercise introduction to enhance performance in dialysis (EXCITE) trial. Kidney Blood Press Res 39(2–3):197–204
doi: 10.1159/000355797
pubmed: 25118055
Battaglia Y, Amicone M, Mantovani A, Combe C, Mitra S, Basile C (2023) Home-based exercise in patients on maintenance dialysis: a systematic review and meta-analysis of randomized clinical trials. Nephrol Dial Transplant 38(11):2550–2561
doi: 10.1093/ndt/gfad102
pubmed: 37202219