KNOWLEDGE AND PRACTICES ON EXERCISE PRESCRIPTION FOR PATIENTS WITH CHRONIC KIDNEY DISEASE AMONG HEALTHCARE PROFESSIONALS IN MEXICO

 

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KNOWLEDGE AND PRACTICES ON EXERCISE PRESCRIPTION FOR PATIENTS WITH CHRONIC KIDNEY DISEASE AMONG HEALTHCARE PROFESSIONALS IN MEXICO

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Kenneth R.
Wilund
Daniel Rivera Soriano ltfdanielriverasoriano@gmail.com Dyalix International Rehabilitación Renal Puebla City Mexico -
Geovana Martin Alemany martinalemany@arizona.edu The University of Arizona School of Nutritional Science and Wellness Tucson Arizona United States -
Kenneth R. Wilund kwilund@arizona.edu The University of Arizona School of Nutritional Science and Wellness Tucson, Arizona United States *
Eloisa Colin Ramirez eloisa.colinr@incmnsz.com Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Vigilancia Epidemiologica México City Mexico -
Paola Miranda Alatriste pvma2000@hotmail.com Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Nefrología y Metabolismo Mineral México City Mexico -
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Introduction: Patients with chronic kidney disease (CKD) often experience reduced muscle mass, functional limitations, and impaired quality of life, largely due to physical inactivity and disease-related complications such as uremic toxicity, anemia, and metabolic disorders. Additional barriers are fatigue, pain, fear of injury, limited time, motivation, or support further hinder exercise participation. This gap between knowledge and practice is compounded by limited understanding of safe and effective exercise prescription, insufficient training among healthcare professionals, and the absence of standardized protocols. In Mexico, these challenges are intensified by a scarcity of structured programs, low access to professional counseling, and limited institutional resources. This study aimed to evaluate the knowledge and practices of Mexican healthcare professionals regarding exercise prescription for CKD patients, identifying key barriers and opportunities to enhance its clinical implementation.

Methods: A cross-sectional study was conducted using a convenience sample of Latin American healthcare professionals who currently or previously worked with patients diagnosed with CKD. The survey was administered online via the Google Forms platform between December 2024 and January 2025. It included 11 closed and open-ended questions, analyzed using descriptive statistics. The study was conducted in accordance with the principles of the Declaration of Helsinki (2013) and international ethical standards for research involving human subjects.

Results: A total of n = 61 responses were obtained. The most frequent professional categories were nurses and nephrologists (42.6%), followed by renal nutrition specialists (13.1%), nurses specialized in nephrology (11.5%), and general practitioners or specialists (13.1%). Of those surveyed, 41% worked exclusively in the private sector, 39.3% in the public sector, and 19.7% in both. Only 37.7% of participants reported knowing of an exercise program, while 62.3% reported not knowing of any. Regarding exercise recommendations, 47.5% indicated that they only recommend walking or light activity, 24.6% do not prescribe exercise, and 21.3% prescribe structured exercise programs; 6.5% reported having a formal institutional program. Furthermore, 14.8% of professionals reported assessing exercise-related risks without using standardized criteria, while only 18.5% used specific tools. Sixty-three percent of respondents who offer an exercise program assessed their functional capacity, and 72.4% reported considering FITT principles. Furthermore, 78.6% reported developing and discussing exercise programs in collaboration with patients. Reported barriers include lack of knowledge (21.31%), concern for patient safety and physical capacity (14.75%), state of mind (13.11%), fear of injury (9.84%), lack of interest (8.20%), physical limitations (8.20%), infrastructure (6.56%), lack of staff knowledge (6.56%), time (6.56%), and financial solvency (4.92%).

Distribution

Evaluation and practice of exercise prescription in chronic kidney disease.



Conclusion: The results of this survey highlight the urgent need to strengthen education and training in clinical exercise prescription within renal healthcare teams. Promoting the development of regional guidelines and training programs is essential to enhance exercise implementation in CKD management.

Kewords