Research Article

Factors Influencing Discontinuation of Exercise Therapy During Hemodialysis

Abstract

Introduction: Various exercise therapy methods have been devised for dialysis patients. Nonetheless, even the best exercise regimen is ineffective if not sustained. This study aims to determine the dropout rate and factors influencing exercise therapy discontinuation during dialysis.
Materials and Methods: This observational, retrospective, and descriptive study included 31 people who underwent exercise therapy during hemodialysis sessions between April 2015 and March 2018 at a hospital. The mean age of the participants was 59.29±11.12 years (range 36–78 years), and the male/female ratio was 24/7. The participants were divided into two groups, the continuation group (15 patients who continued exercise) and the discontinuation group (16 patients who discontinued exercise). Data on physical function history (knee extension muscle strength, one-leg standing time (OLS), and 6-minute walking distance (6 MD)) were collected from medical records. All participants were interviewed using a questionnaire on factors involved in exercise discontinuation from April 2018 to March 2022.
Results: About half of the participants dropped out (51.6%). In particular, the results suggested that body pain was strongly associated with exercise discontinuation. In addition, 8 participants in the discontinuation group died during follow-up after exercise discontinuation (50%).
Conclusion: The study results suggest that it is essential to increase self-efficacy and satisfaction by devising exercise content that meets the individual’s wishes to prevent dropouts during dialysis. In addition, measures against body pain are crucial to continue exercising. The relationship between exercise discontinuation during hemodialysis and mortality should be further examined.

U.S. Department of Health and Human Services. 2021 Annual report: Table of contents [Internet]. 2023 [Upadated 2024 February 27]. Available from: [Link]

Masakane I, Nakai S, Ogata S, Kimata N, Hanafusa N, Hamano T, et al. An overview of regular dialysis treatment in Japan (As of 31 December 2013). Therapeutic Apheresis and Dialysis. 2015; 19(6):540-74. [DOI:10.1111/1744-9987.12378] [PMID]

Isoyama N, Qureshi AR, Avesani CM, Lindholm B, Bàràny P, Heimbürger O, et al. Comparative associations of muscle mass and muscle strength with mortality in dialysis patients. Clinical journal of the American Society of Nephrology. 2014; 9(10):1720-8. [DOI:10.2215/CJN.10261013] [PMID] [PMCID]

Matsubara Y, Matsumoto T, Aoyagi Y, Tanaka S, Okadome J, Morisaki K, et al. Sarcopenia is a prognostic factor for overall survival in patients with critical limb ischemia. Journal of Vascular Surgery. 2015; 61(4):945-50. [DOI:10.1016/j.jvs.2014.10.094] [PMID]

Mori K, Nishide K, Okuno S, Shoji T, Emoto M, Tsuda A, et al. Impact of diabetes on sarcopenia and mortality in patients undergoing hemodialysis. BMC Nephrology. 2019; 20(1):105. [DOI:10.1186/s12882-019-1271-8] [PMID] [PMCID]

Dong ZJ, Zhang HL, Yin LX. Effects of intradialytic resistance exercise on systemic inflammation in maintenance hemodialysis patients with sarcopenia: A randomized controlled trial. International Urology and Nephrology. 2019; 51(8):1415-24. [DOI:10.1007/s11255-019-02200-7] [PMID] [PMCID]

Yamagata K, Hoshino J, Sugiyama H, Hanafusa N, Shibagaki Y, Komatsu Y, et al. Clinical practice guideline for renal rehabilitation: Systematic reviews and recommendations of exercise therapies in patients with kidney diseases. Renal Replacement Therapy. 2019; 5(1):1-9. [DOI:10.1186/s41100-019-0209-8]

Greenwood SA, Lindup H, Taylor K, Koufaki P, Rush R, Macdougall IC, et al. Evaluation of a pragmatic exercise rehabilitation programme in chronic kidney disease. Nephrology, Dialysis, Transplantation. 2012; 27(Suppl 3):iii126-34. [DOI:10.1093/ndt/gfs272] [PMID]

Konstantinidou E, Koukouvou G, Kouidi E, Deligiannis A, Tourkantonis A. Exercise training in patients with end-stage renal disease on hemodialysis: Comparison of three rehabilitation programs. Journal of Rehabilitation Medicine. 2002; 34(1):40-5. [DOI:10.1080/165019702317242695] [PMID]

Wadsworth CT, Krishnan R, Sear M, Harrold J, Nielsen DH. Intrarater reliability of manual muscle testing and hand-held dynametric muscle testing. Physical Therapy. 1987; 67(9):1342-7. [DOI:10.1093/ptj/67.9.1342] [PMID]

Michikawa T, Nishiwaki Y, Takebayashi T, Toyama Y. One-leg standing test for elderly populations. Journal of Orthopaedic Science. 2009; 14(5):675-85. [DOI:10.1007/s00776-009-1371-6] [PMID]

Harada ND, Chiu V, Stewart AL. Mobility-related function in older adults: Assessment with a 6-minute walk test. Archives of Physical Medicine and Rehabilitation. 1999; 80(7):837-41. [DOI:10.1016/S0003-9993(99)90236-8] [PMID]

Parent-Roberge H, Deshayes TA, Fortier C, Marquis K, Lacharité-Lemieux C, Rodrigue C, et al. Feasibility of an intradialytic combined exercise program targeting older adults with end-stage renal disease. Journal of Aging and Physical Activity. 2021; 29(6):905-14. [DOI:10.1123/japa.2020-0359] [PMID]

Feldkötter M, Thys S, Adams A, Becker I, Büscher R, Pohl M, et al. Endurance-oriented training program with children and adolescents on maintenance hemodialysis to enhance dialysis efficacy-DiaSport. Pediatric Nephrology. 2021; 36(12):3923-32. [DOI:10.1007/s00467-021-05114-8]

Viken H, Reitlo LS, Zisko N, Nauman J, Aspvik NP, Ingebrigtsen JE, et al. Predictors of dropout in exercise trials in older adults: The generation 100 study. Medicine and Science in Sports and Exercise. 2019; 51(1):49-55. [DOI:10.1249/MSS.0000000000001742] [PMID]

Luszczynska A. An implementation intentions intervention, the use of a planning strategy, and physical activity after myocardial infarction. Social Science & Medicine. 2006; 62(4):900-8. [DOI:10.1016/j.socscimed.2005.06.043] [PMID]

Martins P, Marques EA, Leal DV, Ferreira A, Wilund KR, Viana JL. Association between physical activity and mortality in end-stage kidney disease: A systematic review of observational studies. BMC Nephrology. 2021; 22(1):227. [DOI:10.1186/s12882-021-02407-w] [PMID] [PMCID]

Files
IssueVol 18 No 2 (2024) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/jmr.v18i2.15980
Keywords
Renal dialysis Exercise Self-efficacy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Noguchi M, Tanaka M, Koshino Y. Factors Influencing Discontinuation of Exercise Therapy During Hemodialysis. jmr. 2024;18(2):229-237.