ArticleClinical and experimental nephrology2026
Participation of physical therapists in medical fee-based dialysis-prevention interventions: a nationwide survey in Japan.
Article in Clinical and experimental nephrology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Physiotherapist-guided, wearable-informed exercise improves 6-minute walk distance in patients with type 2 diabetes, including those with diabetic kidney disease: a prospective study.Diabetology international · 2026Article
- The Current Role of Physiotherapy in Systemic Light-Chain (AL) Amyloidosis and Multiple Myeloma.Life (Basel, Switzerland) · 2026Review
- Awareness of exercise importance, information sources, and adherence in predialysis chronic kidney disease in Japan: a web-based cross-sectional study.BMC nephrology · 2026Article
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Authors and funding
8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundExercise is recommended to prevent dialysis; however, the involvement of physical therapists is not a criterion for reimbursable medical fee calculation in Japan. Consequently, eligible patients may not receive appropriate exercise guidance. We aimed to clarify the extent of physical therapist participation in dialysis-prevention interventions reimbursed under the current Japanese healthcare system and to identify reasons for non-participation related to reimbursement criteria.
methodsIn January 2025, a 30-item questionnaire was distributed to all facility representatives registered with the Japan Physical Therapist Association to investigate medical fees and physical therapist involvement in dialysis prevention. Dialysis-prevention interventions were defined as those reimbursed under the Japanese healthcare system: Lifestyle-Related Disease Management, Diabetes Dialysis Prevention Guidance and Management (including Guidance of Patients with Severe Renal Impairment), and Chronic Kidney Disease (CKD) Dialysis Prevention Guidance and Management.
resultsOf the 10,285 facilities surveyed, 1322 (12.9%) responded. Among these, physical therapists participated in Lifestyle-Related Disease Management, Diabetes Dialysis Prevention Guidance and Management, and CKD Dialysis Prevention Guidance and Management in 4.8%, 3.5%, and 2.3% of facilities, respectively. The most frequently cited reasons for exclusion were "Inclusion of physical therapists is not a strict requirement for medical fee reimbursement," "Insufficient personnel or time," and "No role assigned by the dialysis-prevention team."
conclusionPhysical therapist involvement in dialysis-prevention interventions was limited, primarily due to current medical fee reimbursement criteria. Revising the healthcare system to facilitate their inclusion may enhance the delivery of exercise-based preventive care.
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