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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Daniel
Rivera Soriano
Daniel Rivera Soriano ltfdanielriverasoriano@gmail.com Dyalix International Departamento de 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 -
Keneneth 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.mx Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Departamento de Vigilancia Epidemiológica 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.

Evaluación y práctica de la prescripción de ejercicio en la enfermedad renal crónica.Resultados: Se obtuvieron n = 61 respuestas. Las categorías profesionales más frecuentes fueron enfermeras y nefrólogos (42,6%), seguidas de especialistas en nutrición renal (13,1%), enfermeras especializadas en nefrología (11,5%) y médicos generales o especialistas (13,1%). De los encuestados, el 41% trabajaba exclusivamente en el sector privado, el 39,3% en el sector público y el 19,7% en ambos. Solo el 37,7% de los participantes reportó conocer un programa de ejercicio, mientras que el 62,3% reportó no conocer ninguno. Con respecto a las recomendaciones de ejercicio, el 47,5% indicó que solo recomienda caminar o actividad ligera, el 24,6% no prescribe ejercicio y el 21,3% prescribe programas de ejercicio estructurados; el 6,5% reportó tener un programa institucional formal. Además, el 14,8% de los profesionales reportó evaluar los riesgos relacionados con el ejercicio sin utilizar criterios estandarizados, mientras que solo el 18,5% utilizó herramientas específicas. El 63 % de los encuestados que ofrecen un programa de ejercicios evaluó su capacidad funcional, y el 72,4 % declaró considerar los principios de FITT. Además, el 78,6 % afirmó desarrollar y discutir programas de ejercicios en colaboración con los pacientes. Las barreras reportadas incluyen falta de conocimiento (21,31 %), preocupación por la seguridad y la capacidad física del paciente (14,75 %), estado de ánimo (13,11 %), miedo a lesionarse (9,84 %), falta de interés (8,20 %), limitaciones físicas (8,20 %), infraestructura (6,56 %), falta de conocimiento del personal (6,56 %), tiempo (6,56 %) y solvencia financiera (4,92 %).

Conclusión: Los resultados de esta encuesta resaltan la urgente necesidad de fortalecer la formación y la capacitación en la prescripción de ejercicio clínico en los equipos de atención renal. Promover el desarrollo de guías regionales y programas de capacitación es esencial para mejorar la implementación del ejercicio en el manejo de la ERC.

Kewords