Abstract
The purpose of this study was to define if Outcomes Expectations for Exercise (OEE) and Decisional Balance (DB) scales predict adherence to guided exercise programs and associate with the improvement in physical performance in the dialysis population. Participants (n = 40; age 63.6 ± 12.5 years) completed OEE and DB questionnaires before randomization to the experimental group (n = 20) and control group (n = 20) of a two-phased exercise program—the experimental group received eight weeks of supervised functional exercise and exercise counseling (1st phase) before commencing eight weeks of home-based exercise on non-dialysis days (2nd phase). Both groups performed intradialytic cycling on dialysis days during both study phases. Patients with above-median OEE and DB scores (>3.15 and >1.3, respectively) expressed significantly better adherence to intradialytic cycling (89% vs. 76%, 89% vs. 77%, respectively, p < 0.05). Experimental group patients with an above-median OEE (but not DB) score had significantly better adherence to supervised and home-based functional exercise (93% vs. 81% and 85% vs. 60%, respectively, p < 0.05). Baseline DB score predicted the final result in the hand-grip test and 6-min walk test. Low OEE and, to a lesser degree, low DB questionnaire scores associate with inferior adherence to dialysis bundled and home-based exercise programs and may help define patient subsets in need of intensified motivational input by exercise caregivers.
Highlights
Chronic kidney disease (CKD) has become a public health problem that affects 8%–16% of the population worldwide [1]
Low Outcomes Expectations for Exercise (OEE) and, to a lesser degree, low decisional balance (DB) questionnaire scores associate with inferior adherence to dialysis bundled and home-based exercise programs and may help define patient subsets in need of intensified motivational input by exercise caregivers
The evolution of patients’ attitudes during participation in exercise programs showed positive changes with both scales; the OEE score improved in experimental and control groups, while DB score improved in the experimental group only
Summary
Chronic kidney disease (CKD) has become a public health problem that affects 8%–16% of the population worldwide [1]. CKD patients typically lead very sedentary lifestyles [2], which contributes to increased risk of cardiovascular disease [3], decreased physical function [4,5,6], muscle wasting [7], and overall reduced quality of life [8]. Studies have identified several barriers in HD patients that significantly affect exercise adherence [2,10]. To increase the success of physical exercise programs in the dialysis population, we need tools to predict adherence to these programs and establish patients’ attitudes towards organized physical activity. According to Pinto et al [12], decisional balance (DB) is a psychological construct that has
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