TY - JOUR
T1 - Sustained exercise programs for hemodialysis patients
T2 - The characteristics of successful approaches in Portugal, Canada, Mexico, and Germany
AU - Viana, João L.
AU - Martins, Pedro
AU - Parker, Kristen
AU - Madero, Magdalena
AU - Pérez Grovas, Héctor
AU - Anding, Kirsten
AU - Degenhardt, Stefan
AU - Gabrys, Iwona
AU - Raugust, Shauna
AU - West, Christina
AU - Cowan, Theresa E.
AU - Wilund, Kenneth R.
N1 - Many lessons can be learned from studying the characteristics of these unique exercise programs. First, it is encouraging that a variety of approaches can be used to implement and sustain exercise pro‐ grams with high participation rates (see Table 5). Obtaining funding is clearly beneficial for running a successful program; however, it does not appear to be an absolute requirement (eg, the program in Mexico). Moreover, it is clear that exercise specialists that are hired to manage programs still require an engaged staff that can be trained to help facilitate it. The diversity of sources that have been used to fund these programs is particularly striking. One is funded primarily by in‐ dustry (Portugal), one is subsidized by a private insurance company (Germany), one from a publicly funded health authority (Alberta), and one receives essentially no external funding (Mexico City). Not sur‐ prisingly, the program in Mexico City is the only one of the four that does not employ exercise specialists to manage the program.
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Despite having good intentions, hemodialysis (HD) clinics often fail to sustain exercise programs that they initiate. There are many reasons for this, including a lack of funding, inadequate training of the clinic staff, a lack of exercise professionals to manage the program or train the staff, and the many challenges inherent to exercising a patient population with multiple comorbid diseases. Despite these barriers, there are several outstanding examples of successful exercise programs in HD clinics throughout the world. The aim of this manuscript is to review the characteristics of four successfully sustained HD exercise programs in Portugal, Canada, Mexico, and Germany. We describe the unique approaches they have used to fund and manage their programs, the varied exercise prescriptions they incorporate, the unique challenges they face, and discuss the benefits they have seen. While the programs differ in many regards, a consistent theme is that they each have substantial and committed support from the entire clinic staff, including the nephrologists, administration, nurses, dietitians, and technicians. This suggests that exercise programs in HD clinics can be successfully implemented and sustained provided significant effort is made to foster a culture of physical activity throughout the clinic.
AB - Despite having good intentions, hemodialysis (HD) clinics often fail to sustain exercise programs that they initiate. There are many reasons for this, including a lack of funding, inadequate training of the clinic staff, a lack of exercise professionals to manage the program or train the staff, and the many challenges inherent to exercising a patient population with multiple comorbid diseases. Despite these barriers, there are several outstanding examples of successful exercise programs in HD clinics throughout the world. The aim of this manuscript is to review the characteristics of four successfully sustained HD exercise programs in Portugal, Canada, Mexico, and Germany. We describe the unique approaches they have used to fund and manage their programs, the varied exercise prescriptions they incorporate, the unique challenges they face, and discuss the benefits they have seen. While the programs differ in many regards, a consistent theme is that they each have substantial and committed support from the entire clinic staff, including the nephrologists, administration, nurses, dietitians, and technicians. This suggests that exercise programs in HD clinics can be successfully implemented and sustained provided significant effort is made to foster a culture of physical activity throughout the clinic.
KW - end-stage kidney disease
KW - exercise
KW - hemodialysis
KW - physical activity
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U2 - 10.1111/sdi.12814
DO - 10.1111/sdi.12814
M3 - Article
C2 - 31087375
AN - SCOPUS:85065901926
SN - 0894-0959
VL - 32
SP - 320
EP - 330
JO - Seminars in Dialysis
JF - Seminars in Dialysis
IS - 4
ER -