Attitudes and Barriers to Physical Activity in Hemodialysis Patients: Could Intradialytic Exercise Modify These Factors?
Salhab, Nada | Kooman, Jeroen | Fiaccadori, Enrico | Aljubori, Harith | Karavetian, Mirey
Introduction: This study pioneers in determining the impact of Intradialytic Exercise (IDE) on attitudes and barriers to Physical Activity (PA) in Hemodialysis (HD) patients in the United Arab Emirates, a non-western country with different cultural backgrounds. Subjects and Methods: Forty-one adult HD patients from Al-Qassimi Hospital were recruited for a quasi-experimental intervention with pre-post evaluation. IDE patients trained for 45 minutes per HD session, 2-3 times per week, for 6 months on a static bicycle. Exercise intensity was assessed using the Borg Scale. Participants were educated on the importance of exercise. Results: 30 patients completed the study. The percentage of patients exercising was higher post intervention, but dropped to baseline at the follow up period. At post intervention and follow-up, patient’s knowledge about the benefits and safety of exercise increased, with some patients facing no barrier to PA at the end of the study (p=0.05). There was a significant increase in patients endorsing the “too many medical problems” barrier, and a significant decrease in patients endorsing the “can’t afford to exercise” barrier. Nephrologists and nurses acknowledge the importance of exercise in HD patients, but the former do not prescribe it. Conclusions: Aerobic IDE and knowledge empowerment programs could help HD patients increase their knowledge about exercise benefits and safety and shed some barriers to exercise, although patients appear to easily fall back into their normal habits. Even after an IDE program was adopted in the unit, the medical team is still concerned about the risks of exercise in HD patients.
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