Malgorzata E Kaminska1,2, Robin K Roots1,3, Anurag Singh4. 1. Northern Medical Program, University of Northern British Columbia, Prince George, Canada. 2. Department of Family Practice, The University of British Columbia, Vancouver, Canada. 3. Department of Physical Therapy, The University of British Columbia, Vancouver, Canada. 4. Division of Nephrology, University Hospital of Northern British Columbia, Prince George, Canada.
Abstract
BACKGROUND: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity. The integration of intradialytic cycling during hemodialysis offers patients a form of safe physical activity year-round. OBJECTIVE: This study focuses on better understanding the feasibility and acceptability of implementing intradialytic cycling in a remote northern geographical context. DESIGN: A feasibility study using a mixed-methods explanatory design was adopted for this study. SETTING: The research is conducted in Prince George, British Columbia. PARTICIPANTS: The participants are patients attending a community-based dialysis unit in remote northern British Columbia and health professionals working in the same facility. METHODS: Quantitative measures were captured through cycling logbooks and quality of life measure, and qualitative data were obtained through semi-structured interviews and analyzed using thematic analysis. RESULTS: Six (43%) eligible patients used leg ergometers more than once for a median of 2.5 (interquartile range: 1-4) months and 87% of hemodialysis sessions. Participants cycled for a median of 65 (interquartile range: 39-76) minutes per session, with frequent variability noted between participants and different hemodialysis sessions for the same participant. Nine patients completed the European Quality of Life Health Questionnaire prestudy, with 5 (56%) also completing it poststudy. Interviews with 9 patients, 4 nurses, and 1 physiotherapist led to the identification of themes instrumental to implementation: a supportive community dialysis unit, shared responsibility, knowledge of patients/providers, and benefits associated with engagement. Themes that were identified as being key to acceptability in this remote dialysis unit were trust, connection, and engagement through common values. LIMITATIONS: Due to dialysis unit size, we had a small number of participants. CONCLUSIONS: This study demonstrates the feasibility of implementing best practice in a remote community and provides insight into the elements of context and participation that contribute to acceptability in the implementation of intradialytic cycling.
BACKGROUND: There is growing evidence demonstrating the benefits of intradialytic cycling. However, there are relatively few centers where this practice has been adopted with no reports from hemodialysis units in rural, remote, and northern locations. Maintaining mobility and quality of life for patients on kidney replacement therapy living in remote northern communities is inhibited by inclement weather and lack of access to resources and infrastructure that support physical activity. The integration of intradialytic cycling during hemodialysis offers patients a form of safe physical activity year-round. OBJECTIVE: This study focuses on better understanding the feasibility and acceptability of implementing intradialytic cycling in a remote northern geographical context. DESIGN: A feasibility study using a mixed-methods explanatory design was adopted for this study. SETTING: The research is conducted in Prince George, British Columbia. PARTICIPANTS: The participants are patients attending a community-based dialysis unit in remote northern British Columbia and health professionals working in the same facility. METHODS: Quantitative measures were captured through cycling logbooks and quality of life measure, and qualitative data were obtained through semi-structured interviews and analyzed using thematic analysis. RESULTS: Six (43%) eligible patients used leg ergometers more than once for a median of 2.5 (interquartile range: 1-4) months and 87% of hemodialysis sessions. Participants cycled for a median of 65 (interquartile range: 39-76) minutes per session, with frequent variability noted between participants and different hemodialysis sessions for the same participant. Nine patients completed the European Quality of Life Health Questionnaire prestudy, with 5 (56%) also completing it poststudy. Interviews with 9 patients, 4 nurses, and 1 physiotherapist led to the identification of themes instrumental to implementation: a supportive community dialysis unit, shared responsibility, knowledge of patients/providers, and benefits associated with engagement. Themes that were identified as being key to acceptability in this remote dialysis unit were trust, connection, and engagement through common values. LIMITATIONS: Due to dialysis unit size, we had a small number of participants. CONCLUSIONS: This study demonstrates the feasibility of implementing best practice in a remote community and provides insight into the elements of context and participation that contribute to acceptability in the implementation of intradialytic cycling.
Authors: Stephanie S Frost; R Turner Goins; Rebecca H Hunter; Steven P Hooker; Lucinda L Bryant; Judy Kruger; Delores Pluto Journal: Am J Health Promot Date: 2010 Mar-Apr
Authors: Mansueto Gomes Neto; Filipe Ferrari Ribeiro de Lacerda; Antonio Alberto Lopes; Bruno Prata Martinez; Micheli Bernardone Saquetto Journal: Clin Rehabil Date: 2018-02-26 Impact factor: 3.477
Authors: Keith P McCullough; Hal Morgenstern; Rajiv Saran; William H Herman; Bruce M Robinson Journal: J Am Soc Nephrol Date: 2018-12-17 Impact factor: 10.121
Authors: Deborah J Bowen; Matthew Kreuter; Bonnie Spring; Ludmila Cofta-Woerpel; Laura Linnan; Diane Weiner; Suzanne Bakken; Cecilia Patrick Kaplan; Linda Squiers; Cecilia Fabrizio; Maria Fernandez Journal: Am J Prev Med Date: 2009-05 Impact factor: 5.043