title: Feasibility and Safety of Intradialysis Yoga and Education in Maintenance Hemodialysis Patients.
abstract: OBJECTIVE
  Patients with end-stage renal disease on maintenance hemodialysis are much more sedentary than healthy individuals. The purpose of this study was to assess the feasibility and safety of a 12-week intradialysis yoga intervention versus a kidney education intervention on the promotion of physical activity.
  
  
  METHODS
  We randomized participants by dialysis shift to either 12-week intradialysis yoga or an educational intervention. Intradialysis yoga was provided by yoga teachers to participants while receiving hemodialysis. Participants receiving the 12-week educational intervention received a modification of a previously developed comprehensive educational program for patients with kidney disease (Kidney School). The primary outcome for this study was feasibility based on recruitment and adherence to the interventions and safety of intradialysis yoga. Secondary outcomes were to determine the feasibility of administering questionnaires at baseline and 12 weeks including the Kidney Disease-Related Quality of Life-36.
  
  
  RESULTS
  Among 56 eligible patients who approached for the study, 31 (55%) were interested and consented to participation, with 18 assigned to intradialysis yoga and 13 to the educational program. A total of 5 participants withdrew from the pilot study, all from the intradialysis yoga group. Two of these participants reported no further interest in participation. Three withdrawn participants switched dialysis times and therefore could no longer receive intradialysis yoga. As a result, 13 of 18 (72%) and 13 of 13 (100%) participants completed 12-week intradialysis yoga and educational programs, respectively. There were no adverse events related to intradialysis yoga. Intervention participants practiced yoga for a median of 21 sessions (70% participation frequency), with 60% of participants practicing at least 2 times a week. Participants in the educational program completed a median of 30 sessions (83% participation frequency). Of participants who completed the study (n = 26), baseline and 12-week questionnaires were obtained from 85%.
  
  
  CONCLUSIONS
  Our pilot study of 12-week intradialysis yoga and 12-week educational intervention reached recruitment goals but with less than targeted completion and adherence to intervention rates. This study provided valuable feasibility data to increase follow-up and adherence for future clinical trials to compare efficacy.
authors: Division of General Internal Medicine and Pediatrics, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Health Services Research, Nashville, Tennessee; Osher Center for Integrative Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: gurjeet.birdee@vanderbilt.edu.
authors: Gurjeet S
authors: GS
authors: Birdee
authors: Division of General Internal Medicine and Pediatrics, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Health Services Research, Nashville, Tennessee.
authors: Russell L
authors: RL
authors: Rothman
authors: Division of General Internal Medicine and Pediatrics, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Health Services Research, Nashville, Tennessee; Osher Center for Integrative Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
authors: Stephanie J
authors: SJ
authors: Sohl
authors: Yoga as Therapy North America, California.
authors: Dolphi
authors: D
authors: Wertenbaker
authors: Yoga as Therapy North America, California; California State University, California.
authors: Amy
authors: A
authors: Wheeler
authors: Yoga as Therapy North America, California.
authors: Chase
authors: C
authors: Bossart
authors: Division of General Internal Medicine and Pediatrics, Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Health Services Research, Nashville, Tennessee.
authors: Oluwaseyi
authors: O
authors: Balasire
authors: Division of Nephrology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
authors: T Alp
authors: TA
authors: Ikizler
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010865:Pilot Projects; D011788:Quality of Life; D006435:Renal Dialysis; D057185:Sedentary Behavior; D011795:Surveys and Questionnaires; D015013:Yoga