Supervised Walking Program Improves Fitness and Quality of Life in Renal Patients

Physical exercise can improve symptoms, function, and mental health. However, many patients with renal disease do not meet physical activity guidelines. Exercise programs affiliated with hospitals may be able to reduce fears and improve exercise levels in that patient population. Leonora Chao, RD, and colleagues conducted a study to assess the effects of a 3-month supervised renal Nordic walking (NW) program on the fitness and quality of life of renal outpatients.

Results of the study were reported online during the NKF Spring Clinical Meetings. The presentation was titled Effects of a Renal Nordic Walking Program on Quality of Life and Fitness in Renal Patients: A Randomized Controlled Trial.

The study included 30 participants 45 to 84 years of age. Patients were randomized to one of two groups: NW (n=15) or non-NW (n=15). The NW group was offered two supervised NW sessions per week; the non-NW group continued their usual activities.

Outcomes of interest were: weight, handgrip strength, 30-second sit-to-stand test (30-STS), 6-minute-walk test (6MWT), and Kidney Disease and Quality of Life questionnaire (KDQOL-36). Outcome measurements were taken at baseline and at 3-months. During the 3-month study period, daily steps were recorded using a Fitbit tracker. Using the intention-to-treat principle, the researchers calculated median changes in outcomes from baseline to 3 months between the two groups, and tested with a Brown-Mood median test.

Of the 30 participants, ten were kidney transplant recipients, 14 were pre-dialysis, three were receiving hemodialysis, and three were receiving peritoneal dialysis. Two patients in the non-NW group were lost to follow-up; missing data were minimal.

At 3 months, compared with the non-NW group, participants in the NW group had a median increase in body mass index (+0.3 kg/m2), handgrip strength (+2.1 kg), 30-STS (+1), 6MWT (+31.5 m), and several domains of the KDQOL-36 (effect of kidney disease; burden of kidney disease; and symptoms and problems). There were no significant differences in the median average daily steps between the two groups (NW, 7857 steps; non-NW, 8083 steps).

In summary, the researchers said, “The NW group had greater improvements in handgrip strength (1.1 kg), KDQOL-36 scores, and exceeded the minimal clinically important difference of 14.0-30.5 m for 6MWT (41.5  m). Post-study comments from participants were consistent with perceptions of improvements in quality of life. A group-based supervised renal NW program may provide benefits to renal patients as part of their clinical care.”

Source: Chao L, Neufeld S, Ngo V, et al. Effects of a renal Nordic walking program on quality of life and fitness in renal patients: a randomized controlled trial. Abstract of a presentation at the National Kidney Foundation 2020 Spring Clinical Meetings; abstract #228.