Evidence map›Paper›PMID 30524718›Full record

ArticleClinical kidney journal2018

Implementing a theory-based intradialytic exercise programme in practice: a quality improvement project.

Hannah M L Young, Sushant Jeurkar, Darren R Churchward, Maurice Dungey, David J Stensel, Nicolette C Bishop, Sharlene A Greenwood, Sally J Singh, Alice C Smith, James O Burton

Abstract read
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In one paragraph

Article in Clinical kidney journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
  5. Addressing feasibility challenges to delivering intradialytic exercise interventions: a theory-informed qualitative study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hannah M L YoungLeicester Kidney Exercise Team, Department of Infection, Immunity and Inflammation and John Walls Renal Unit, Leicester General Hospital, Leicester, UK.ORCID 0000-0002-4249-9060
Sushant JeurkarPhysiotherapy Department, Addenbrooks Hospital, Cambridge University Hospitals, NHS Foundation Trust, Cambridge, UK.
Darren R ChurchwardLeicester Kidney Exercise Team, Department of Infection, Immunity and Inflammation and John Walls Renal Unit, Leicester General Hospital, Leicester, UK.
Maurice DungeyNational Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
David J StenselNational Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Nicolette C BishopNational Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Sharlene A GreenwoodDepartment of Physiotherapy and Renal Medicine, King's College Hospital and Department of Renal Medicine, King's College London, London, UK.
Sally J SinghCentre for Exercise and Rehabilitation Science, Leicester Biomedical Research Unit, Department of Respiratory Medicine, Glenfield Hospital, University Hospitals of Leicester, Leicester, UK.
Alice C SmithLeicester Kidney Exercise Team, Department of Infection, Immunity and Inflammation and John Walls Renal Unit, Leicester General Hospital, Leicester, UK.
James O BurtonLeicester Kidney Exercise Team, Department of Infection, Immunity and Inflammation and John Walls Renal Unit, Leicester General Hospital, Leicester, UK.

Funding

Department of Health CS-2013-13-014Department of Health DRF-2016-09-015
6 · The paper itself

Abstract

backgroundResearch evidence outlines the benefits of intradialytic exercise (IDE), yet implementation into practice has been slow, ostensibly due to a lack of patient and staff engagement. The aim of this quality improvement project was to improve patient outcomes via the introduction of an IDE programme, evaluate patient uptake and sustainability and enhance the engagement of routine haemodialysis (HD) staff with the delivery of the IDE programme.

methodsWe developed and refined an IDE programme, including interventions designed to increase patient and staff engagement that were based on the Theoretical Domains Framework (TDF), using a series of 'Plan, Do, Study, Act' (PDSA) cycles. The programme was introduced at two UK National Health Service HD units. Process measures included patient uptake, withdrawals, adherence and HD staff involvement. Outcome measures were patient-reported functional capacity, anxiety, depression and symptomology. All measures were collected over 12 months.

resultsA total of 95 patients were enrolled in the IDE programme; 64 (75%) were still participating at 3 months, decreasing to 41 (48%) at 12 months. Adherence was high (78%) at 3 months, decreasing to 63% by 12 months. The provision of IDE by HD staff accounted for a mean of 2 (5%) sessions per 3-month time point. Patients displayed significant improvements in functional ability (P = 0.01) and a reduction in depression (P = 0.02) over 12 months, but the effects seen were limited to those who completed the programme.

conclusionsA theory-based IDE programme is feasible and leads to improvement in functional capacity and depression. Sustaining IDE over time is complicated by high levels of patient withdrawal from the programme. Significant change at an organizational level is required to enhance sustainability by increasing HD staff engagement or access to professional exercise support.

Indexed as

end-stage renal diseaseexercisehaemodialysisphysical activityquality improvement

Identifiers

PMID30524718
PMCPMC6275440

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.