Original Paper

Exercise Coaching and Rehabilitation Counseling Improve Quality of Life for Predialysis and Dialysis Patients
Sally S. Fitts^a, Mark R. Guthrie^b, Christopher R. Blagg<sup>a,b

a</sup>Northwest Kidney Centers, and
^bUniversity of Washington, Seattle, Wash., USA

Address of Corresponding Author

Nephron 1999;82:115-121 (DOI: 10.1159/000045386)

  Key Words

• Rehabilitation
• Exercise
• Quality of life
• Dialysis
• Predialysis
• Chronic renal failure
• End-stage renal disease

  Abstract

Advances in medical treatment have improved the rehabilitation potential of predialysis (P) and dialysis (D) patients, but deficits remain in their physical and vocational functioning. We studied 18 P (expected to begin dialysis in 6-12 months) and 18 D patients (on dialysis 1-5 years) for 1 year. Exercise coaching and rehabilitation counseling were provided at no cost for the first 6 months to half of each patient group (rehabilitation group = R); the other half were assigned randomly to controls (C). No R services were provided during 6 months of follow-up. PR walked further in 6 min at 6 months (+3.9 m) and 12 months (+4.1 m) than initially (p < 0.01). Hematocrit increased in R (p < 0.05), but not in C. Symptom scores were stable in D, worsened 21% in PC, and improved 15% in PR. Sickness impact profile scores were better in PR than PC at 6 months (p < 0.05) and 12 months (NS). Comorbidity correlated with symptoms (r = +0.34, p < 0.05), self-rated affect (r = -0.35, p < 0.05), and self-rated Karnofsky index of disability (r = -0.37, p < 0.05), but not with physician-rated affect or physician-rated Karnofsky index of disability. Thus, quality of life was stable or improved in PR, but declined in PC; PR benefited more than DR. Rehabilitation services are more beneficial before than after patients stabilize on dialysis, and quality of life monitoring should continue indefinitely.

  Author Contacts

Sally S. Fitts, PhD
Northwest Kidney Centers, 700 Broadway
Seattle, WA 98122 (USA)
Tel. +1 206 292 2771 (ext. 2138), Fax +1 206 860 5821
E-Mail sfitts@u.washington.edu

  Article Information

Accepted: January 15, 1999
Number of Print Pages : 7
Number of Figures : 2, Number of Tables : 4, Number of References : 32