Efficacy of Nordic Walking in Improving Walking Ability in Patients on Peritoneal Dialysis: A Randomized Controlled Trial

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Abstract Title *

Efficacy of Nordic Walking in Improving Walking Ability in Patients on Peritoneal Dialysis: A Randomized Controlled Trial

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Co-author 1

Rena Sumura Sonoda r.sumura1118@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan *

Co-author 2

Kiyotaka Uchiyama kiyo.0817.piyo@gmail.com International University of Health and Welfare Narita Hospital Nephrology Tokyo Japan -

Co-author 3

Yuka Inaba yuka.ina1105@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 4

Chiaki Kasahara chiaki1101k@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 5

Tomoki Sato aizu-to-s@hotmail.co.jp Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 6

Ayaka Wada ayakadai07@gmail.com Tokyo Medical University Nephrology Tokyo Japan -

Co-author 7

Shohei Yamada innocent.shohei17@gmail.com St.Marianna University School of Medicine Nephrology Kanagawa Japan -

Co-author 8

Shingo Urate slc22a12@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 9

Mai Yanagi maimew963@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 10

Satoshi Kinugasa teeveepersonalities@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 11

Junichi Kunoki anb38407@nifty.com Japanese Red Cross Medical Center Spine Orthopedics Tokyo Japan -

Co-author 12

Yoshitaka Ishibashi yi431204@gmail.com Japanese Red Cross Medical Center Nephrology Tokyo Japan -

Co-author 13

Co-author 14

Co-author 15

Introduction

The importance of maintaining exercise capacity to achieve independence in activities of daily living is well recognized in patients undergoing peritoneal dialysis (PD) at home. However, the multifaceted effects of exercise therapy in these patients and the optimal exercise protocols have not yet been established. Nordic walking (NW), a four-point walking technique, has been shown to improve exercise tolerance in patients with various chronic diseases in the home setting. Although several studies have investigated the efficacy of NW in different chronic conditions, its effectiveness in improving exercise capacity among patients on PD remains unclear.

Methods

Patients with PD and sarcopenia and/or musculoskeletal pain were randomly assigned to the intervention or the usual care group. The intervention group was instructed to perform NW for 20–30 min/day at least three times/week for a total of 12 weeks. The primary endpoint was the change in 6-min walking distance (6MWD), and the secondary endpoints were changes in measures related to sarcopenia, nutrition, metabolism, and PD.

Results

The study included 13 and 11 participants in the intervention and usual care groups, respectively, with a median age of 74.0 ± 6.8 years and a median 6MWD of 391.0 ± 58.1 m. The instructional compliance was 96% in the intervention group. The change in 6MWD was 33.1 ± 33.5 m in the intervention group and 4.9 ± 32.9 m in the usual care group, with a significant improvement in the intervention group (P = 0.05). Among the secondary outcomes, the changes in total cholesterol and peritoneal Kt/V were significantly different between the intervention and usual care groups (−28.5 ± 43.6 vs. 17.7 ± 30.5; P = 0.01 and 0.3 ± 0.4 vs. −0.06 ± 0.2; P = 0.02, respectively).

Conclusion

NW can improve walking ability in patients on PD with sarcopenia or musculoskeletal pain, with a high adherence rate.

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