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Physical Activity and Functioning in Home Dialysis Patients

16 november 2016 uppdaterad av: Patricia Painter, University of Utah
This study will compare physical activity levels and physical functioning in patients treated with home dialysis vs. those treated with in-center dialysis. The investigators will first compare prevalent patients, and will also compare the two groups longitudinally in incident patients over the first 18 months of beginning the dialysis treatments. Patients will be tested for physical functioning using standard performance-based testing such as gait speed, chair stand, balance test, as well as self-reported limitations in activities of daily living. The investigators will monitor physical activity using step counters and activity questionnaires. Blood samples will be drawn at each testing time to measure inflammatory markers. A pilot study of home dialysis patients will be done to determine the effects of an independent home-based exercise program on physical functioning and inflammatory markers. For this pilot study, 30 patients will be randomized into exercise intervention and usual care with testing at baseline and again after 3 months of the intervention.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Aim 1: To determine levels of physical functioning, physical activity, incidence of frailty and inflammation status in prevalent home dialysis patients in the University of Utah Home Dialysis program and compare them to in-center hemodialysis patients who are matched for age, gender, comorbidities and dialysis vintage. Hypothesis 1: Patients on home therapies will have higher physical functioning, be more active and fewer will be frail compared to matched patients treated with in-center hemodialysis.

Aim 2: To determine the patterns of change in physical functioning and physical activity over the first 18 months of initiating dialysis therapy. Hypothesis 2: Physical functioning and physical activity will be maintained in patients initiating home dialysis therapy, whereas, those initiating in-center dialysis will deteriorate in physical functioning and physical activity.

Aim 3: To determine the effects of counseling and encouragement of physical activity in prevalent home dialysis patients on physical functioning, physical activity. Hypothesis 3: Compared to usual care, patients who are counseled and encouraged to participate in independent home walking exercise will improve physical functioning and health-related quality of life.

Aim 4: To determine the association of inflammation with physical functioning in home dialysis patients and with changes in physical activity. Hypothesis 4: Lower physical functioning is associated with inflammation and increased physical activity will improve physical functioning and reduce the associated inflammation.

Studietyp

Interventionell

Inskrivning (Faktisk)

120

Fas

  • Inte tillämpbar

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 90 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • on dialysis for 3 months (for prospective study and for pilot intervention)
  • 18 years of age
  • ambulatory
  • no progressive neuromuscular disease
  • no orthopedic or rheumatologic problems that would be exacerbated by physical function testing
  • English speaking
  • able to understand and provide consent for participation

Exclusion Criteria:

  • progressive neuromuscular disease that may result in limitations
  • orthopedic or rheumatologic disease that may be exacerbated by physical function testing
  • physical functioning
  • unstable angina or angina upon exertion
  • terminal illness with life expectancy less than 12 months
  • MI or CABG within the last year
  • NYHA Class III or IV CHF

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Inget ingripande: Physical Function/Activity

cross-sectional comparison study of physical function/activity, frailty and inflammation measures in prevalent home Dx and prevalent in-center hemodialysis patients.

Subjects: Forty-five prevalent home dialysis patients will be recruited and tested once for all outcome measures. Forty-five prevalent in-center hemodialysis patients will be identified from prevalent patients in the University of Utah in-center dialysis system who are matched for gender, age, comorbidities and time on dialysis as the home dialysis patients who have been tested. Consenting patients will be tested for all outcome measures once and compared to the home dialysis group.
Inget ingripande: Incident Patients

Study 2: is a longitudinal cohort study of incident patients starting either home dialysis or in-center hemodialysis.

Consenting patients will be tested upon initiation of dialysis therapy and every 6 months for 18 months to track physical functioning /activity, frailty and inflammation over time.
Övrig: Independent Home Exercise
pilot study of independent home exercise training in home dialysis (PD only) patients. Consenting patients will be tested at baseline, then randomized into exercise training or usual care (no prescribed change in activity levels) and retested after 3 months.
Övrig: exercise training
Pilot study of independent home exercise training (walking or cycling exercise plus low level resistance exercise) for 3 months. Patients will be given specific recommendations for type, frequency, duration and progression of their program and will be contacted weekly by study staff to assess progress and evaluation for any problems. This is a 3 month exercise training intervention in 15 subjects (and 15 no-exercise controls).
Andra namn:
  • Independent Home Exercise Training

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
change in short physical performance battery
Tidsram: baseline, 3 months, 6 months 12 mo, 18 mo
baseline, 3 months, 6 months 12 mo, 18 mo

Sekundära resultatmått

Resultatmått
Tidsram
change in inflammation
Tidsram: baseline, 6 mo, 12 mo, 18 mo
baseline, 6 mo, 12 mo, 18 mo

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

University of Utah

Samarbetspartners

Baxter Healthcare Corporation

Utredare

  • Huvudutredare: Patricia Painter, U of U PHYSICAL THERAPY - COH

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 juni 2012

Primärt slutförande (Faktisk)

1 juni 2016

Avslutad studie (Faktisk)

1 juni 2016

Studieregistreringsdatum

Först inskickad

16 maj 2012

Först inskickad som uppfyllde QC-kriterierna

17 maj 2012

Första postat (Uppskatta)

21 maj 2012

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

17 november 2016

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

16 november 2016

Senast verifierad

1 november 2016

Mer information

Termer relaterade till denna studie

Nyckelord

Andra studie-ID-nummer

  • IRB_00053828

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