Home-based exercise in chronic kidney disease: Exploring the feasibility and effect of a digitally delivered physical activity and exercise content

Background

People living with non-dialysis dependant chronic kidney disease are susceptible to declining physical function. Physical function is considered an important phenotype of syndromes such as sarcopenia and frailty. Physical activity is a well-established way to counteract declining function. However, physical activity levels in this population are low. Digital health interventions (DHIs) provide a novel and potentially accessible way to provide lifestyle education.

Aims

To develop a physical activity and exercise content as part of a larger complex DHI (My Kidneys and Me (MK&M)). To explore the measurement properties of the 12-Item Short-Form Health Survey (SF-12), which was used as a self-reported outcome measure to assess effect. To assess the feasibility of delivering remote physical activity and exercise content as part of the MK&M. To investigate the effect of the MK&M programme on self-reported physical function, sarcopenia risk, and physical activity levels.

Methods

A scoping review and patient and public involvement supported the co-development of the physical activity resources. Measurement properties of the SF-12 were investigated by the COSMIN guidelines. Usage behaviours were investigated to assess the feasibility of the MK&M programme. Finally, a preliminary analysis was performed to assess differences between groups (intervention versus control) and associations between usage and effect.

Results

The development procedures highlighted that patients may require multiple resources to aid home-based exercise. The SF-12 and its subscales are adequate to assess lower body mobility. Usage behaviours suggested that patients preferred to use the MK&M programme in shorter bouts. Associations between MK&M usage and physical function were observed, however, this result is subject to limitations.

Discussion

The MK&M programme has the potential to preserve physical function. Results suggested that refinement to the programme may be required. The thesis highlights the importance of outcome measure choice, development procedures, and the application of usage behaviours when examining the effect(s) of complex DHIs.