Flywheel Exercise for CKD

Washington D.C. Veterans Affairs Medical Center

Status: Unknown

Conditions: Chronic Kidney Disease stage3; Chronic Kidney Disease stage4

Treatments: Behavioral: Eccentric overload exercise

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT03582982

01903

Details and patient eligibility

About

Among Veterans, the prevalence of chronic kidney disease (CKD) is reported to be as high as 47.3% and a third higher than the general population. Muscle wasting and dysfunction have been identified as primary consequences of CKD. Disease-induced reductions in lean tissue adversely affect muscle fatigability. Consequently, muscle fatigability may serve as a potential limiting factor that contributes to activity limitations. However, there is a lack of evidence informing our understanding of muscle fatigability in patients with CKD. Dialysis treatment is a major factor contributing to the high financial costs of CKD care. Thus, in addition to potential health and quality of life benefits, treatments capable of maintaining kidney function or delaying the onset of dialysis treatment would provide substantial socio-economic benefit. Both lean body mass and muscle fatigability may be improved through strength training. Eccentric-overload (i.e. muscle lengthening) progressive resistance exercise (PRE) has been shown to be safe and effective for a variety of chronic conditions. Eccentric PRE using portable flywheel technology may provide a clinically viable treatment option to combat muscle impairments in CKD given the cost effectiveness and minimal space requirements for this mode of exercise.

The purpose of this study is to assess feasibility of the eccentric-overload PRE regimen for Veterans with CKD stage 3 & 4 predialysis using a prospective single-arm pre-test post-test intervention design. The primary aim of the project is to determine the effects of eccentric-overload PRE on muscle fatigability in Veterans with CKD Stages 3 & 4 predialysis. Feasibility of the regimen will be determined by the time needed to complete the 4-exercise regimen and the perceived exertion levels reported by the study participants.

Enrollment: 20 estimated patients

Sex: All

Ages: 18 to 84 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ambulatory patients (with or without a gait aid)
• CKD stage 3 or 4
• patients receiving care at the DC VAMC Renal Service
• the ability to speak and read English
• orientation to person, place, and time

Exclusion criteria

• unable to speak English
• acute renal failure
• pregnant
• unable to follow study instructions
• any uncontrolled cardiovascular or musculoskeletal problems that would make participation in this study unsafe

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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20 participants in 1 patient group

Eccentric overload exercise

Experimental group

Treatment:

Behavioral: Eccentric overload exercise