Abstract: TH-PO818
A Novel Exercise Intervention, Home-Based and Video-Supervised, Improved Cardiorespiratory Fitness and Physical Performance in CKD
Session Information
- Health Maintenance, Nutrition, Metabolism
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Health Maintenance‚ Nutrition‚ and Metabolism
- 1400 Health Maintenance‚ Nutrition‚ and Metabolism
Authors
- Begue, Gwenaelle, California State University Sacramento, Sacramento, California, United States
- Nicorici, Alina, University of California Davis, Davis, California, United States
- Ghafar, Nargies, University of California Davis, Davis, California, United States
- Batra, Radhika, University of California Davis, Davis, California, United States
- Badhesha, Harshanna, University of California Davis, Davis, California, United States
- Vargas, Chenoa R., University of California Davis, Davis, California, United States
- Kim, Tae Youn, University of California Davis, Davis, California, United States
- Hamdan, Hiba, University of California Davis, Davis, California, United States
- Jue, Thomas, University of California Davis, Davis, California, United States
- Gamboa, Jorge, Vanderbilt University Medical Center, Nashville, Tennessee, United States
- Roshanravan, Baback, University of California Davis, Davis, California, United States
Background
Sarcopenia is a prevalent complication in chronic kidney disease (CKD) and a central component of the frailty phenotype associated with adverse clinical outcomes. In the era of COVID, there is a critical need for practical, safe, interactive, and personalized home-based exercise targeting improvements in physical function in vulnerable patients living with CKD.
Methods
The ESTEEM-VIDA CKD pilot randomized clinical trial tests the efficacy of a home-based, video-supervised, and personalized exercise program on cardiorespiratory fitness (CRF) and physical performance in patients with moderate-severe CKD. Exercise (EX, n=12) consisted of 30-40min exercise sessions, thrice a week for 12 weeks: high-intensity interval training, strength training, and moderate intensity walking. One week of video-supervised exercise alternates with one week of self-directed exercise. Each one-week video-supervised session was conducted by exercise trainers using a videoconference tool, while self-directed exercise weeks used pre-recorded exercise videos. Controls (CTL, n=5) received diet and exercise counseling at baseline. Pre- and post-intervention CRF (VO2peak) and total work were measured using a graded cycle ergometer test and physical performance was assessed by the 6-minutes walking distance (6MWT) test. The effect of exercise on change in CRF and 6MWT using linear mixed effects models was tested.
Results
Mean age was 62 ±10y with 47% females and 53% with diabetes. Mean eGFR was 34.4±11.8 ml/min per 1.73m2. Mean total work and 6MWT at baseline were 31.7 ±17kJ and 494 ±51m, respectively. EX was associated with a 6.9kJ increase in total work (95% CI 2, 12; p=0.008) compared to CTL independent of change in VO2peak, suggesting improved muscular efficiency following training. EX was associated with a 43m increase in 6MWT (95% CI 11, 75; p=0.008) compared to CTL. VO2peak did not differ between groups (p=0.99).
Conclusion
Preliminary findings suggest a home-based, video supervised, personalized exercise program is feasible and efficacious in improving muscular and physical performance in CKD. It provides a tool for studying metabolic and molecular health and may shed new light on the pathophysiology of sarcopenia in CKD.
Funding
- NIDDK Support