Effects of a Walking Intervention in Older Patients with CKD: Feasibility Study

摘要 慢性肾病（CKD）患者的特征是身体功能水平低下， 身体不活动。肾功能不全可能对肾功能减退有累加作用。 与衰老相关的功能和活动能力。这项建议是为了进行一项试点研究， 这将为更大规模的纵向试验的设计、样本量和适当措施提供信息， 老年CKD患者的身体功能、活动能力和体力活动。本研究的目的 （a）使用国际功能分类（ICF）来指导身体功能的测量， 和B），以测试对慢性肾脏病老年患者的功能和活动性的可行性和反应， 老年CKD患者的独立居家步行干预。这项研究将使用混合的 评估干预措施有效性的定性和定量措施，并将 将80名> 60岁的患者随机分配到步行干预。这些数据将用于估计影响 用于确定较大随机试验所需的样本量。这些数据还可以用于 临床实践中身体机能和活动性的测量指南 步行以保持移动性。身体功能评估和体格检查建议 活动不是CKD患者常规管理的一部分，因此迫切需要 进一步研究CKD患者护理的这一临床重要且被严重忽视的方面。使用 ICF框架将研究重点从临床和死亡率结果转移到 对病人来说非常重要的东西。身体机能测量的测试，用于 临床实践使患者护理超越了对实验室生物标志物的关注， 更深入地了解整体健康状况。对步行影响的测试 干预将为未来大规模研究和临床实践的设计提供信息。

Abstract Patients with Chronic Kidney Disease (CKD) are characterized by low levels of physical function and physical inactivity. It is possible that kidney dysfunction has an additive effect on the decrement in functioning and mobility that is associated with aging. This proposal is for a pilot study to acquire data that will inform the design, sample size, and appropriate measures for a larger longitudinal trial of physical functioning, mobility and physical activity in older patients with CKD. The aims of this study are a) to use the International Classification of Functioning (ICF) to guide measurement of physical function and mobility in older patients with CKD and b) to test the feasibility and responses to an independent home walking intervention in older patients with CKD. The study will use a blend of qualitative and quantitative measures to assess the effectiveness of the intervention, and will randomize 80 patients > 60 years to the walking intervention. The data will be used to estimate effect size for determining sample size needed for a larger randomized trial. The data can also be used to guide for measurement of physical functioning and mobility in clinical practice and for recommending walking to maintain mobility. Assessment of physical function and recommendation for physical activity are not part of the routine management of patients with CKD, so there is a critical need to for further study this clinically important and sorely neglected aspect of patient care in CKD. The use of the ICF framework moves the focus of research away from clinical and mortality outcomes to those that are of significant importance to patients. The testing of measures of physical function for use in clinical practice moves patient care beyond a focus on laboratory biomarkers to using measures that will provide more in-depth understanding of overall health. The testing of the effects of a walking intervention will inform design of future large-scale studies as well as clinical practice.