Tawney K W, Tawney P J, Hladik G, Hogan S L, Falk R J, Weaver C, Moore D T, Lee M Y
Department of Medicine, Division of Nephrology and Hypertension, Chapel Hill, NC, USA.
Am J Kidney Dis. 2000 Sep;36(3):581-91. doi: 10.1053/ajkd.2000.16197.
Patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) are typically sedentary and functionally limited as a consequence of their condition. The purpose of this study is to test the effect of a lifestyle physical rehabilitation program (The Life Readiness Program) on physical function in patients with ESRD undergoing HD. Physical function was measured by the Kidney Disease Quality of Life Short Form (KDQOL-SF) physical function score (range, 0 to 100). Eighty-two patients were randomly assigned to a 6-month rehabilitation program (intervention; n = 39) or to standard clinical management alone (control; n = 43). The groups were frequency matched by age, sex, ethnicity, and diabetes as the cause of ESRD. General linear modeling of the change in physical function score was used for multivariate analysis. Physical function scores were not different between groups at baseline. Change in physical function score increased significantly in the intervention group compared with the control group when data were adjusted for the matching variables and adequacy of dialysis (3.2, -3.6; P = 0.04). Additionally, the control group reported more problems with work or daily functions because of emotional problems (P: </= 0.05). In this brief 6-month intervention, The Life Readiness Program showed the therapeutic benefit of a lifestyle rehabilitation program on functional outcomes and health-related quality of life for patients with ESRD undergoing hemodialysis.
接受血液透析（HD）的终末期肾病（ESRD）患者通常因病情而久坐不动且功能受限。本研究的目的是测试一种生活方式身体康复计划（生命准备计划）对接受HD的ESRD患者身体功能的影响。身体功能通过肾脏病生活质量简表（KDQOL-SF）身体功能评分来衡量（范围为0至100）。82名患者被随机分配到为期6个月的康复计划（干预组；n = 39）或仅接受标准临床管理（对照组；n = 43）。两组在年龄、性别、种族以及作为ESRD病因的糖尿病方面进行了频率匹配。使用身体功能评分变化的一般线性模型进行多变量分析。两组在基线时身体功能评分无差异。在对匹配变量和透析充分性进行数据调整后，干预组的身体功能评分变化与对照组相比显著增加（3.2，-3.6；P = 0.04）。此外，对照组报告因情绪问题在工作或日常功能方面存在更多问题（P≤0.05）。在这一为期6个月的简短干预中，生命准备计划显示出生活方式康复计划对接受血液透析的ESRD患者的功能结局和健康相关生活质量具有治疗益处。
