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Efficacy of Exercise Therapy Initiated in the Early Phase After Kidney Transplantation: A Pilot Study

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Efficacy of Exercise Therapy Initiated in the Early Phase After Kidney Transplantation: A Pilot Study

Objective

In patients with kidney transplant (KT), frailty is a predictor of adverse outcomes.
Outcomes of exercise therapy in patients with KT, particularly the efficacy of early
exercise after KT, have not been evaluated. We investigated the effect of exercise
intervention beginning early after KT on physical performance, physical activity,
quality of life, and kidney function in patients with KT.

Methods

KT recipients who underwent surgery with usual care plus exercise training from a
prospective cohort (exercise group; n = 10) and those with usual care alone from a
historical cohort (control group; n = 14) were included in this study. Early exercise
comprised supervised aerobic training and physical activity instruction from day 6
to 2 months after KT. The following outcomes were measured: 6-minute walking distance,
isometric knee extensor strength, gait speed, physical activity, quality of life,
and estimated glomerular filtration rate.

Results

Analyses of covariance, adjusted for baseline values, revealed significant mean differences
between exercise and control groups at 2 months after KT in 6-minute walking distance
(+44.4 m,
P = .03) and isometric knee extensor strength (+8.1%body weight,
P = .03). No significant between-group differences were found in gait speed, physical
activity, and quality of life. The analysis of variance for comparison of the area
under the recovery curves of estimated glomerular filtration rate after KT revealed
no significant difference between groups.

Conclusion

Supervised aerobic training and physical activity instruction initiated in the early
phase after KT can improve physical performance without adversely affecting kidney
function.

Article Info

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Footnotes

Authorship: S.Y.: Participated in research design, the writing of the paper, the performance of the research, and data analysis. Dr. R.M.: Participated in research design, the writing of the paper, and the performance of the research. Dr. T.K.: Participated in research design, the writing of the paper, and data analysis. Dr. K.H.: Participated in the writing of the paper, the performance of the research, and data analysis. Dr. D.I.: Participated in research design, the writing of the paper, and the performance of the research. Dr. F.N.: Participated in research design, the writing of the paper, and the performance of the research. Dr. N.H.: Participated in research design, the writing of the paper, and the performance of the research. Dr. K.N.: Participated in research design, the writing of the paper, and the performance of the research. Dr. T.I.: Participated in research design, the writing of the paper, and the performance of the research. Dr. E.M.: Participated in research design, the writing of the paper, and the performance of the research. Professor A.M.: Participated in the writing of the paper, and the performance of the research. Professor K.Y.: Participated in research design, the writing of the paper, and the performance of the research.

Financial Disclosure: The authors declare that they have no relevant financial interests.

Support: Dr Matsuzawa is supported by the JSPS KAKENHI Grant Number 16K16466 . Dr Matsunaga is supported by the JSPS KAKENHI Grant Number JP26350631 & JP19K11372 .

Identification

DOI: https://doi.org/10.1053/j.jrn.2019.11.005

Copyright

© 2020 by the National Kidney Foundation, Inc. All rights reserved.

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