Division of Nephrology and Hypertension, Department of Medicine, University of California-San Diego, San Diego, California.
Division of Nephrology and Hypertension, Department of Medicine, University of California-San Diego, San Diego, California.
Am J Kidney Dis. 2023 Jul;82(1):75-83. doi: 10.1053/j.ajkd.2022.12.011. Epub 2023 Feb 17.
RATIONALE & OBJECTIVE: People with end-stage kidney disease (ESKD) have very low physical activity, and the degree of inactivity is strongly associated with morbidity and mortality. We assessed the feasibility and effectiveness of a 12-week intervention coupling a wearable activity tracker (FitBit) and structured feedback coaching versus wearable activity tracker alone on changes in physical activity in hemodialysis patients.
Randomized controlled trial.
SETTING & PARTICIPANTS: 55 participants with ESKD receiving hemodialysis who were able to walk with or without assistive devices recruited from a single academic hemodialysis unit between January 2019 and April 2020.
All participants wore a Fitbit Charge 2 tracker for a minimum of 12 weeks. Participants were randomly assigned 1:1 to a wearable activity tracker plus a structured feedback intervention versus the wearable activity tracker alone. The structured feedback group was counseled weekly on steps achieved after randomization.
The outcome was step count, and the main parameter of interest was the absolute change in daily step count, averaged per week, from baseline to completion of 12 weeks intervention. In the intention-to-treat analysis, mixed-effect linear regression analysis was used to evaluate change in daily step count from baseline to 12-weeks in both arms.
Out of 55 participants, 46 participants completed the 12-week intervention (23 per arm). The mean age was 62 (± 14 SD) years; 44% were Black, and 36% were Hispanic. At baseline, step count (structured feedback intervention: 3,704 [1,594] vs wearable activity tracker alone: 3,808 [1,890]) and other participant characteristics were balanced between the arms. We observed a larger change in daily step count in the structured feedback arm at 12 weeks relative to use of the wearable activity tracker alone arm (Δ 920 [±580 SD] versus Δ 281 [±186 SD] steps; between-group difference Δ 639 [±538 SD] steps; P<0.05).
Single-center study and small sample size.
This pilot randomized controlled trial demonstrated that structured feedback coupled with a wearable activity tracker led to a greater daily step count that was sustained over 12 weeks relative to a wearable activity tracker alone. Future studies are required to determine longer-term sustainability of the intervention and potential health benefits in hemodialysis patients.
Grants from industry (Satellite Healthcare) and government (National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK).
Registered at ClinicalTrials.gov with study number NCT05241171.
终末期肾病（ESKD）患者的身体活动度非常低，且其不活动程度与发病率和死亡率密切相关。我们评估了在血液透析患者中，将可穿戴活动追踪器（Fitbit）与结构化反馈教练相结合的 12 周干预措施与单独使用可穿戴活动追踪器相比，对身体活动变化的可行性和有效性。
随机对照试验。
2019 年 1 月至 2020 年 4 月期间，从单家学术血液透析单位招募了 55 名接受血液透析且能够行走（有无辅助设备均可）的 ESKD 患者参与本研究。
所有参与者至少佩戴 Fitbit Charge 2 追踪器 12 周。参与者被随机分配 1:1 接受可穿戴活动追踪器加结构化反馈干预与单独使用可穿戴活动追踪器。在随机分组后，结构化反馈组每周接受一次关于达到的步数的咨询。
结局是步数，主要关注的参数是从基线到 12 周干预完成时每周平均每日步数的绝对变化。在意向治疗分析中，采用混合效应线性回归分析评估了两条手臂从基线到 12 周时每日步数的变化。
在 55 名参与者中，有 46 名完成了 12 周的干预（每组 23 名）。平均年龄为 62（±14 标准差）岁；44%为黑人，36%为西班牙裔。在基线时，步数（结构化反馈干预：3704 [1594]与单独使用可穿戴活动追踪器：3808 [1890]）和其他参与者特征在两组之间平衡。与单独使用可穿戴活动追踪器相比，在结构化反馈组中，每日步数在 12 周时的变化更大（Δ920 [±580 标准差]与 Δ281 [±186 标准差]步；组间差异 Δ639 [±538 标准差]步；P<0.05）。
单中心研究和样本量小。
这项初步随机对照试验表明，与单独使用可穿戴活动追踪器相比，结构化反馈与可穿戴活动追踪器相结合可导致每日步数增加，并在 12 周内持续增加。需要进一步的研究来确定该干预措施的长期可持续性以及对血液透析患者的潜在健康益处。
来自行业（卫星医疗保健）和政府（美国国立糖尿病、消化和肾脏疾病研究所（NIDDK））的赠款。
在 ClinicalTrials.gov 上注册，注册号为 NCT05241171。
Zotero 插件
