title: Exercise program to enhance physical performance and quality of life of older hemodialysis patients: a feasibility study.
abstract: OBJECTIVE
  Evaluate the feasibility of implementing a combined in-hospital and home-based exercise program in older hemodialysis (HD) patients.
  
  
  METHODS
  A prospective longitudinal 12-week pilot study.
  
  
  METHODS
  A university hospital HD unit and patients' homes.
  
  
  METHODS
  A convenience sample of nine older (>55 years) patients undergoing HD.
  
  
  METHODS
  An individualized exercise program performed on HD days (3/week) and at home (2-3/week), including aerobic, flexibility, strength exercises and patient education.
  
  
  METHODS
  Feasibility measure: patient participation. Exercise performance: Duke Activity Status Index (DASI); 2-min walk test (2MWT); Timed-up-and-go (TUG). Quality of life: The Illness Intrusiveness Ratings Scale (IIRS); The Kidney Disease Quality of Life Questionnaire (KDQOL).
  
  
  RESULTS
  The mean (SD) age of the patients was 68.1 (7.1). Participation in the in-hospital supervised exercise program was high, with patients exercising during 89% of HD sessions, but was lower for the unsupervised home-based component (56% exercised ≥ 2 times/week). Patients showed a gradual increase in the amount of exercise performed over 12 weeks. The 2MWT, TUG, IIRS and the KDQOL physical composite score demonstrated moderate responsiveness, while the DASI score exhibited only limited responsiveness.
  
  
  CONCLUSIONS
  This exercise program and the outcome measures were feasible for older HD patients: in-hospital participation was high, and physical performance and QOL measures exhibited moderate levels of responsiveness. Future, larger studies are needed to demonstrate whether intra-dialysis exercise, with or without home exercise, can lead to improved outcomes in this population.
authors.affiliation: Toronto Rehabilitation Institute, 550 University Avenue, Toronto, ON, M5G 2A2, Canada.
authors.forename: Mika L
authors.initials: ML
authors.lastname: Nonoyama
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ponikvar
authors.forename: S Vanita
authors.initials: SV
authors.lastname: Jassal
authors.forename: Pia
authors.initials: P
authors.lastname: Kontos
authors.forename: Gerald M
authors.initials: GM
authors.lastname: Devins
authors.forename: Lily
authors.initials: L
authors.lastname: Spanjevic
authors.forename: Carol
authors.initials: C
authors.lastname: Heck
authors.forename: Judi
authors.initials: J
authors.lastname: Laprade
authors.forename: Gary
authors.initials: G
authors.lastname: Naglie
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010809:Physical Fitness; D011446:Prospective Studies; D011788:Quality of Life; D006435:Renal Dialysis