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Kidney Week

Abstract: PO2057

A Pilot Randomized Clinical Trial to Embed Technology-Enabled Group-Based Exercise Programming in the Clinic: The Exercise Is Medicine in Chronic Kidney Disease Trial

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Ziolkowski, Susan, Stanford University School of Medicine, PALO ALTO, California, United States
  • Anand, Shuchi, Stanford University School of Medicine, PALO ALTO, California, United States
  • Bootwala, Ahad Amin, Emory University School of Medicine, Atlanta, Georgia, United States
  • Li, Jianheng, Emory University School of Medicine, Atlanta, Georgia, United States
  • Pham, Nhat M., Stanford University School of Medicine, PALO ALTO, California, United States
  • Cobb, Jason, Emory University School of Medicine, Atlanta, Georgia, United States
  • Lobelo, Felipe, Emory University School of Medicine, Atlanta, Georgia, United States
Background

Physical activity (PA) is associated with improvement of cardiovascular health, transplant outcomes, and survival in CKD. We evaluated the feasibility and effectiveness of integrating referral from nephrology clinics to a technology-enabled and/or group-based exercise program.

Methods

We conducted a pilot trial to test the ACSM Exercise is Medicine (EIM) framework in persons with eGFR <45 not on dialysis in San Jose, CA and Atlanta, GA. Participants were randomized to 1. mobile health (mHealth) group: wearable PA trackers + counseling, or 2. EIM group: mHealth + twice weekly small group exercise sessions. Physical and mental health assessments were done at baseline, 8, and 16 wks. Multilevel mixed models evaluated group differences.

Results

Of 56 participants, 86% belonged to a racial/ethnic minority. In intention-to-treat analyses, the EIM group increased moderate-vigorous PA compared to the mHealth group (time x intervention p=0.02) at 8 wks, no differences were observed between group daily step count. In as-treated analyses, daily step count, distance covered, light and moderate-vigorous PA improved in the EIM group and declined in the mHealth group at 8 wks (p ≤0.05) but group differences faded at 16 wks. No differences in physical function or mental health were found.

Conclusion

We successfully integrated recruitment, assessment, and group-based fitness interventions into clinical settings servicing minority patients with advanced CKD. Despite poor baseline measures, improvements in PA were observed in the EIM group, particularly in persons who participated in exercise sessions.

Intention to treat (A) and as-treated (B) analyses: change moderate to vigorous physical activity (MVPA) in EIM vs mHealth

Funding

  • Private Foundation Support