Kate Lyden1,2, Robert Boucher3, Guo Wei3,4, Na Zhou3, Jesse Christensen5, Glenn M Chertow6, Tom Greene4, Srinivasan Beddhu7,8. 1. Department of Kinesiology, University of Massachusetts, Amherst, Massachusetts. 2. Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado. 3. Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City, Utah. 4. Division of Biostatistics, University of Utah School of Medicine, Salt Lake City, Utah. 5. Department of Physical Medicine and Rehabilitation, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah. 6. Division of Nephrology, Stanford University, Palo Alto, California. 7. Division of Nephrology and Hypertension, University of Utah School of Medicine, Salt Lake City, Utah srinivasan.beddhu@hsc.utah.edu. 8. Medical Service, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah.
Abstract
BACKGROUND AND OBJECTIVES: We tested the feasibility of reducing sedentary behavior common in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We carried out a Sit Less, Interact, Move More intervention in a 24-week parallel-group, randomized controlled trial in patients with stages 2-5 CKD. In the intervention group (n=54), accelerometry performed at baseline and repeated every 4 weeks was used to develop and monitor adherence to individualized plans targeting sedentary and stepping durations. The control group (n=52) was provided national physical activity recommendations; accelerometry was performed at baseline and every 8 weeks. Between-groups changes from baseline to the average follow-up values at weeks 8, 16, and 24 of the sedentary and stepping durations were the coprimary end points. RESULTS: The mean age was 69±13 years. Fourteen percent were on dialysis or received a kidney transplant. Eight percent of the control group and 17% of the intervention group were lost to follow-up. Sedentary and stepping durations did not change in the control group. Within the intervention group, the maximum decrease in sedentary duration (-43; 95% confidence interval, -69 to -17 min/d) and increase in stepping duration (16; 95% confidence interval, 7 to 24 min/d) and the number of steps per day (1265; 95% confidence interval, 518 to 2012) were seen at week 20. These attenuated at week 24. In mixed effects models, overall treatment effects between groups on sedentary (-17; 95% confidence interval, -43 to 8 min/d) and stepping (6; 95% confidence interval, -3 to 15 min/d) durations and the number of steps per day, a secondary end point (652; 95% confidence interval, -146 to 1449), were not significantly different. The intervention significantly reduced secondary end points of body mass index (-1.1; 95% confidence interval, -1.9 to -0.3 kg/m2) and body fat percentage (-2.1%; 95% confidence interval, -4.4% to -0.2%). CONCLUSIONS: It is feasible to reduce sedentary duration and increase stepping duration in patients with CKD, but these were not sustained. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: National Health and Nutrition Examination Survey (NHANES), NCT02970123.
BACKGROUND AND OBJECTIVES: We tested the feasibility of reducing sedentary behavior common in CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We carried out a Sit Less, Interact, Move More intervention in a 24-week parallel-group, randomized controlled trial in patients with stages 2-5 CKD. In the intervention group (n=54), accelerometry performed at baseline and repeated every 4 weeks was used to develop and monitor adherence to individualized plans targeting sedentary and stepping durations. The control group (n=52) was provided national physical activity recommendations; accelerometry was performed at baseline and every 8 weeks. Between-groups changes from baseline to the average follow-up values at weeks 8, 16, and 24 of the sedentary and stepping durations were the coprimary end points. RESULTS: The mean age was 69±13 years. Fourteen percent were on dialysis or received a kidney transplant. Eight percent of the control group and 17% of the intervention group were lost to follow-up. Sedentary and stepping durations did not change in the control group. Within the intervention group, the maximum decrease in sedentary duration (-43; 95% confidence interval, -69 to -17 min/d) and increase in stepping duration (16; 95% confidence interval, 7 to 24 min/d) and the number of steps per day (1265; 95% confidence interval, 518 to 2012) were seen at week 20. These attenuated at week 24. In mixed effects models, overall treatment effects between groups on sedentary (-17; 95% confidence interval, -43 to 8 min/d) and stepping (6; 95% confidence interval, -3 to 15 min/d) durations and the number of steps per day, a secondary end point (652; 95% confidence interval, -146 to 1449), were not significantly different. The intervention significantly reduced secondary end points of body mass index (-1.1; 95% confidence interval, -1.9 to -0.3 kg/m2) and body fat percentage (-2.1%; 95% confidence interval, -4.4% to -0.2%). CONCLUSIONS: It is feasible to reduce sedentary duration and increase stepping duration in patients with CKD, but these were not sustained. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER: National Health and Nutrition Examination Survey (NHANES), NCT02970123.
Authors: Brigid M Lynch; Ester Cerin; Neville Owen; Anna L Hawkes; Joanne F Aitken Journal: Cancer Causes Control Date: 2011-06-09 Impact factor: 2.506
Authors: Carrie D Patnode; Jillian T Henderson; Jamie H Thompson; Caitlyn A Senger; Stephen P Fortmann; Evelyn P Whitlock Journal: Ann Intern Med Date: 2015-09-22 Impact factor: 25.391
Authors: D W Dunstan; E L M Barr; G N Healy; J Salmon; J E Shaw; B Balkau; D J Magliano; A J Cameron; P Z Zimmet; N Owen Journal: Circulation Date: 2010-01-11 Impact factor: 29.690