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

摘要 慢性肾脏病(CKD)患者的特点是身体功能低下和 缺乏体力活动。肾功能不全可能对肾功能减退有相加作用。 与衰老相关的功能和活动能力。这项提议是为了进行一项试验性研究，以获取数据 这将为更大规模的纵向试验提供设计、样本量和适当的措施 老年慢性肾脏病患者的身体功能、活动和体力活动。这项研究的目的 A)使用国际功能分类(ICF)指导对体力活动的测量 老年慢性肾脏病患者的功能和活动度，以及b)测试其可行性和对 对老年慢性肾脏病患者进行独立的回家步行干预。这项研究将使用混合的 评估干预效果的定性和定量措施，并将 随机选择80名60岁的患者进行步行干预。这些数据将被用于评估效果 用于确定大型随机试验所需样本量的大小。该数据还可用于 临床实践中身体功能和活动能力的测量指南和推荐指南 走路以保持机动性。体能评定及体能推荐 活动不是慢性肾脏病患者常规管理的一部分，因此迫切需要 进一步研究CKD患者护理在临床上的重要性和被严重忽视的这一方面。对.的使用 ICF框架将研究的重点从临床和死亡率结果转移到 这对病人来说非常重要。人体机能指标的测试 临床实践使患者护理从关注实验室生物标记物转向使用 将提供对整体健康状况更深入的了解。对步行效果的测试 干预措施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.