Southern Alberta Renal Program, Calgary, Alberta.
Clinical and Health Sciences, University of South Australia, Adelaide, Australia; Satellite Healthcare, San Jose, California.
J Ren Nutr. 2021 Jul;31(4):421-426. doi: 10.1053/j.jrn.2020.11.010. Epub 2021 Feb 26.
OBJECTIVE(S): Patients with end-stage kidney disease requiring hemodialysis suffer frailty and poor physical function. Exercise can improve physical function; however, barriers exist to intradialytic exercise programs. The objective of this study was to explore patients' reasons for not exercising in an extant intradialytic exercise program.
We conducted a retrospective analysis reporting the reasons for not exercising in an intradialytic exercise program in two hemodialysis centers over a 4-week period. We explored whether patient characteristics and the presence of an exercise professional were associated with missed exercise sessions.
Seventy-five patients participating in the intradialytic exercise program completed 57% of prescribed intradialytic exercise sessions. The three most frequently reported reasons from patients not exercising were refusal (24%), followed by fatigue (19%) and symptoms (14%). Patients were more than twice as likely to exercise if a kinesiologist was present (odds ratio [OR]: 2.26, confidence interval [CI]: 1.5, 3.4 P = .03). They were less likely to exercise if they were women (OR: 0.66, CI: 0.45, 0.95 P = .002), had been on dialysis greater than 60 months (OR: 0.55, CI: 0.37, 0.80 P < .002), or had more than two comorbid conditions (OR: 0.63, CI: 0.43, 0.90, P = .01).
Patient adherence to intradialytic exercise programs is strongly associated with the presence of exercise professionals.
需要血液透析的终末期肾病患者身体虚弱，身体机能较差。运动可以改善身体机能；然而，间歇性血液透析运动计划存在障碍。本研究旨在探讨患者在现有间歇性血液透析运动计划中不运动的原因。
我们进行了一项回顾性分析，报告了在两个血液透析中心的 4 周期间，患者不参加间歇性血液透析运动计划的原因。我们探讨了患者特征和运动专业人员的存在是否与错过运动课程有关。
75 名参加间歇性血液透析运动计划的患者完成了规定的间歇性血液透析运动课程的 57%。患者不运动的三个最常见原因是拒绝（24%），其次是疲劳（19%）和症状（14%）。如果有运动生理学家在场，患者进行运动的可能性是两倍多（优势比 [OR]：2.26，置信区间 [CI]：1.5，3.4 P=0.03）。如果患者是女性（OR：0.66，CI：0.45，0.95 P=0.002）、透析时间超过 60 个月（OR：0.55，CI：0.37，0.80 P<0.002）或有超过两种合并症（OR：0.63，CI：0.43，0.90，P=0.01），他们进行运动的可能性较小。
患者对间歇性血液透析运动计划的依从性与运动专业人员的存在密切相关。
