JMIR Publications

ABSTRACT

Background:

End-stage renal disease (ESRD) patients receiving regular hemodialysis (HD) are a highly sedentary population with high mortality. Sufficient physical activity may reduce the risk of cardiovascular-related diseases and all-cause mortality in the HD population.

Objective:

This study aimed to evaluate the effectiveness of wearable devices, a health management platform, and social media for improving the physical activity of HD patients, with the goal of establishing a new intervention model.

Methods:

In a 24-week prospective study, a total of 31 clinically stable HD patients were enrolled. All participants were assigned home exercises based upon walking and calisthenics and patients were provided with wearable devices that collected exercise-related data. All participants maintained dietary diaries using a smartphone app. All dietary and exercise information was then uploaded to a health management platform. Suggestions about diet and exercise were provided, and a social media group was created to inspire the participants. Physical performance testing was performed at baseline and during weeks 4, 8, 12, 16 and 24, using monthly step counts, sit-to-stand tests (STS-10 and STS-60), 6-minute walking distance (6MWT) and hand grip strength (HGS). The Kidney Disease Quality of Life survey (KDQOL-36TM) questionnaire was used to assess quality of life. Nutrition status was evaluated by subjective global assessment (SGA).

Results:

A total of 25 participants completed the study; 14 were male, and the mean participant age was 51.22 years. After the intervention, the STS-10 test reduced by 4.37 seconds, the STS-60 increased 12 fold, the 6MWT increased by 55 meters, and the HGS also increased relative to the baseline. The monthly step count increased to an average of 46,437 steps. At the end of the study, the KDQOL-36TM and SGA scores were elevated. By logistical regression, the monthly step count correlated positively with 6MWT and SGA; the more steps per month achieved, the longer the distance in the 6MWT and higher SGA score were noted.

Conclusions:

The application of wearable devices, a health management platform, and social media support not only strengthened physical activity but also improved the quality of life and nutrition in people with regular HD. These results outline a new model to promote healthy lifestyle behaviors in HD patients. Clinical Trial: The study protocol was approved by the Research Ethics Committee of National Taiwan University Hospital (No. 201812145RINA). The ClinicalTrials.gov number was NCT05281497.