Exercise benefits and barriers perceived by hemodialysis patients: relationship with fatigue and physical activity level

Year 2024, , 206 - 212, 25.03.2024

Fatma Cansu Aktaş Arslan , Tülin Düger

https://doi.org/10.32322/jhsm.1440103

Abstract

Aims: The aim of our study was to determine the attitudes of hemodialysis (HD) patients towards exercise and to determine the relationship between physical activity level (PAL) and fatigue.
Methods: This cross-sectional study was conducted with 113 HD patients (57.8±5.96) aged 18-65 years. Personal information form, fatigue impact scale (FIS), international physical activity questionnaire short form (IPAQ-SF), and dialysis patient-perceived exercise benefits and barriers scale (DPEBBS) were used as data collection tools.
Results: The mean DPEBBS total score was 64.35±6.15 and PAL was low. The most commonly perceived exercise benefits were preventing muscle atrophy and maintaining a stable body weight, while the most common exercise barriers (EB) were not understanding how to exercise and fatigue. There was a weak negative correlation between the PAL of the patients with the Perceived Exercise Barriers subscale (r=-0.275, p=0.003) and a weak positive correlation between the total scale score (r=0.318, p=0.001). There was a weakly significant positive correlation between the Cognitive, Physical, Psychosocial sub-dimension of Fatigue and Total FIS with the Perceived Exercise Barriers sub-dimension (r=0.337, p=0.000; r=0.358, p=0.000; r=0.334, p=0.000; r=0.387, p=0.000). A very weakly significant negative correlation was found between the Fatigue Cognitive, Physical, Psychosocial sub-dimension and Fatigue Total Impact Dimension with the total scale score (r=-0.247, p=0.008; r=-0.234, p=0.013), r=-0.222, p=0.018, r=-0.243, p=0.003) .
Conclusion: HD patients had higher perceptions of the benefits of exercise. It was concluded that the perception of EB decreased as PAL increased and the perception of EB increased as fatigue levels increased. It is recommended that specialized physiotherapists evaluate HD groups at risk in detail and create individual interventions that support HD patients' compliance with exercise.

Keywords

dialysis, exercise perception, physical activity, fatigue

Ethical Statement

The study was carried out with the permission of the Sakarya University of Applied Sciences Ethics Committee (Date: 07.07.2023, Decision No: 33/4).

Supporting Institution

The authors declared that this study has received no financial support.

Project Number

None.

References

• 1. Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl. 2022;12(1):7-11.
• 2. Zhang F, Wang H, Huang L, Bai Y, Wang W, Zhang H. Effect of exercise interventions for sleep quality in patients with chronic kidney disease: a systematic review and meta-analysis. Int Urol Nephrol. 2023;55(5):1193-1204.
• 3. Bikbov B, Purcell CA, Levey AS, et al. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-733.
• 4. Beckwith H, Thind A, Brown EA. Perceived life expectancy among dialysis recipients: a scoping review. Kidney Med. 2023;5(8):100687.
• 5. Molsted S, Bennett PN, Wilund K, et al. Nurses' and medical doctors' attitudes towards exercise for people with chronic kidney disease in Denmark. J Ren Care. 2023;49(3):206-216. doi: 10.1111/jorc.12445
• 6. Salehi F, Dehghan M, Mangolian Shahrbabaki P, Ebadzadeh MR. Effectiveness of exercise on fatigue in hemodialysis patients: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2020;12(1):19.
• 7. Böhm J, Monteiro MB, Thomé FS. Effects of aerobic exercise during haemodialysis in patients with chronic renal disease: a literature review. J Bras Nefrol. 2012;34(2):189-194.
• 8. Jayaseelan G, Bennett PN, Bradshaw W, Wang W, Rawson H. Exercise benefits and barriers: the perceptions of people receiving hemodialysis. Nephrol Nurs J. 2018;45(2):185-219.
• 9. Hargrove N, El Tobgy N, Zhou O, et al. Effect of aerobic exercise on dialysis-related symptoms in individuals undergoing maintenance hemodialysis: a systematic review and meta-analysis of clinical trials. Clin J Am Soc Nephrol. 2021;16(4):560-574.
• 10. Doğru BV, Kasar KS. Hemodiyaliz hastalarının fiziksel aktivite düzeyleri, algılanan egzersiz yararları, engelleri ve ilişkili faktörler. HUHEMFAD. 2022;9(1):10-16.
• 11. Zelle DM, Klaassen G, Van Adrichem E, Bakker SJ, Corpeleijn E, Navis G. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol. 2017;13(3):152-168.
• 12. Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clin Infect Dis. 1994;18(Supplement_1):S79-S83.
• 13. Öztürk M. Üniversitede eğitim-öğretim gören öğrencilerde uluslararası fiziksel aktivite anketinin geçerliliği ve güvenirliği ve fiziksel aktivite düzeylerinin belirlenmesi. Yayımlanmamış Yüksek Lisans Tezi, Ankara: Hacettepe Üniversitesi. 2005.
• 14. Taş D, Akyol A. Diyaliz hastalarında Egzersiz Yararları/Engelleri Ölçeği” nin Türkçeye uyarlanması: geçerlik ve güvenirlik çalışması. Nefrol Hemş Derg. 2019;14(1):17-25.
• 15. Kılıç Z, Uzdil N. Dialysis symptoms on exercise perception of hemodialysis patients. Turk J Nephrol. 2023;32(1):39-47.
• 16. Darawad MW, Khalil AA. Jordanian dialysis patients' perceived exercise benefits and barriers: a correlation study. Rehabil Nurs J. 2013;38(6):315-322.
• 17. Jayaseelan G, Bennett PN, Bradshaw W, Wang W, Rawson H. Exercise benefits and barriers: the perceptions of people receiving hemodialysis. Nephrol Nurs J. 2018;45(2):185-219.
• 18. Lightfoot CJ, Wilkinson TJ, Song Y, Burton JO, Smith AC. Perceptions of exercise benefits and barriers: the influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis. J Nephrol. 2021;34(6):1961-1971.
• 19. Wang CJ, Johansen KL. Are dialysis patients too frail to exercise? Semin Dialysis. 2019;32(4):291-296.
• 20. Kirkman DL, Bohmke N, Carbone S, et al. Exercise intolerance in kidney diseases: physiological contributors and therapeutic strategies. Am J Physiol-Renal Physiol. 2021;320(2):F161-F173.
• 21. Musolino M, Presta P, Cianfrone P, et al. Self-reported physical inactivity and mood disturbances in end-stage kidney disease (ESKD) Patients on chronic dialysis treatment. J Clin Med. 2023;12(22):7160.
• 22. Avesani CM, Trolonge S, Deléaval P, et al. Physical activity and energy expenditure in haemodialysis patients: an international survey. Nephrol Dialysis Transplant. 2012;27(6):2430-2434.
• 23. Matsuzawa R, Matsunaga A, Wang G, et al. Habitual physical activity measured by accelerometer and survival in maintenance hemodialysis patients. Clin J Am Soc Nephrol. 2012;7(12):2010-2016.
• 24. Bruinius JW, Hannan M, Chen J, et al. Self-reported physical activity and cardiovascular events in adults with CKD: findings from the CRIC (chronic renal insufficiency cohort) study. Am J Kidney Dis. 2022;80(6):751-761.
• 25. Huang M, Lv A, Yang F, et al. Impacts of cognition of exercise on physical activity participation in hemodialysis patients. Semin Dialysis. 2023;36(5):366-373.
• 26. Regolisti G, Maggiore U, Sabatino A, et al. Interaction of healthcare staff ’s attitude with barriers to physical activity in hemodialysis patients: a quantitative assessment. PLoS One. 2018;13(4):e0196313.
• 27. Faigenbaum AD, Rebullido TR. Understanding physical literacy in youth. Strength Conditioning J. 2018;40(6):90-94.
• 28. Hannan M, Bronas UG. Barriers to exercise for patients with renal disease: an integrative review. J Nephrol. 2017;30(6):729-741.
• 29. Moorman D, Suri R, Hiremath S, et al. Benefits and barriers to and desired outcomes with exercise in patients with ESKD. Clin J Am Soc Nephrol. 2019;14(2):268-276.
• 30. Zeng J, Bennett PN, Hill K, Borlace M, Xu Q. The exercise perceptions of people treated with peritoneal dialysis. J Renal Care. 2020;46(2):106-114.