Tarca Brett, Jesudason Shilpanjali, Bennett Paul N, Wycherley Thomas P, Ferrar Katia E
Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.
Central Northern Adelaide Renal and Transplantation Service Clinical Research Group, Royal Adelaide Hospital, Adelaide, Australia.
Kidney Int Rep. 2024 Feb 5;9(5):1298-1309. doi: 10.1016/j.ekir.2024.01.057. eCollection 2024 May.
People receiving peritoneal dialysis experience physical function decline, impairing their ability to complete everyday activities, leading to poorer quality of life. Physical factors, including cardiorespiratory fitness, muscle strength, physical activity, and sedentary behavior are associated with physical function. However, little is known about this relationship, or temporal changes of these factors in this cohort. This study aimed to explore modifiable physical factors that are associated with physical function, identify which factor has the strongest influence, and explore temporal changes.
Adults receiving peritoneal dialysis underwent objective and self-reported physical function, cardiorespiratory fitness, muscle strength, physical activity and sedentary behavior assessments 3 times over a 12-month observation period (at baseline, 6 months, and 12 months).
Eighty-two participants underwent assessments All modifiable physical factors were predominantly moderate to strongly associated with physical function at baseline. Cardiorespiratory fitness had the strongest and most consistent influence with every meter conferring a 0.08-unit ( < 0.01) and 0.01-unit ( < 0.05) increase in self-report and objective physical function score, respectively. Temporal changes were observed for modifiable physical factors with significant mean changes in cardiorespiratory fitness (-9.8%), quadricep strength (-5%), moderate-to-vigorous (-25.9%) and total (-16.2%) physical activity, and sedentary behavior (+7.1%).
The results of this study indicate that cardiorespiratory fitness could be routinely monitored to detect risk of physical function decline and targeted through intervention to enhance physical function for people receiving peritoneal dialysis. Nevertheless, all factors should be considered when designing interventions to mitigate temporal changes and induce the numerous health benefits offered by being physically active.
接受腹膜透析的患者会出现身体功能下降，这损害了他们完成日常活动的能力，导致生活质量下降。包括心肺功能、肌肉力量、身体活动和久坐行为在内的身体因素与身体功能相关。然而，对于这一关系以及该队列中这些因素的时间变化知之甚少。本研究旨在探索与身体功能相关的可改变身体因素，确定哪个因素影响最强，并探索时间变化。
接受腹膜透析的成年人在12个月的观察期内（基线、6个月和12个月）接受了3次客观和自我报告的身体功能、心肺功能、肌肉力量、身体活动和久坐行为评估。
82名参与者接受了评估。所有可改变的身体因素在基线时大多与身体功能中度至高度相关。心肺功能的影响最强且最一致，每增加1米，自我报告的身体功能得分增加0.08单位（P<0.01），客观身体功能得分增加0.01单位（P<0.05）。观察到可改变身体因素的时间变化，心肺功能（-9.8%）、股四头肌力量（-5%）、中度至剧烈（-25.9%）和总身体活动（-16.2%）以及久坐行为（+7.1%）有显著的平均变化。
本研究结果表明，可对心肺功能进行常规监测，以检测身体功能下降的风险，并通过干预进行针对性改善，从而提高接受腹膜透析患者的身体功能。然而，在设计干预措施以减轻时间变化并带来身体活动所提供的诸多健康益处时，应考虑所有因素。
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