Copyright
©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
Supervised vs home-based exercise program in kidney transplant recipients: A pilot pragmatic non-randomized study
Anna Crepaldi, Giovanni Piva, Nicola Lamberti, Michele Felisatti, Luca Pomidori, Yuri Battaglia, Fabio Manfredini, Alda Storari, Pablo Jesús López-Soto
Anna Crepaldi, Giovanni Piva, Alda Storari, Unit of Nephrology, University Hospital of Ferrara, Ferrara 44121, Emilia-Romagna, Italy
Anna Crepaldi, Department of Nursing, Instituto Maimónides de Investigación Biomédica de Córdoba, Cordoba 14004, Andalusia, Spain
Nicola Lamberti, Fabio Manfredini, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Emilia-Romagna, Italy
Michele Felisatti, Luca Pomidori, Esercizio Vita Medical Fitness, Ferrara 44124, Emilia-Romagna, Italy
Yuri Battaglia, Department of Medicine, University of Verona, Verona 37100, Veneto, Italy
Pablo Jesús López-Soto, Department of Nursing, Maimonides Biomedical Research Institute of Cordoba, University of Cordoba, Reina Sofía University Hospital, Cordoba 14004, Andalusia, Spain
Co-first authors: Anna Crepaldi and Giovanni Piva.
Author contributions: Battaglia Y, Manfredini F, Storari A and Lopez-Soto PJ designed the research study; Crepaldi A, Piva G, Lamberti N, Felisatti M and Pomidori L performed the research; Crepaldi A, Piva G, Lamberti N and Lopez-Soto PJ analyzed the data and wrote the original manuscript. All authors have read and approved the final manuscript.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the CE AVEC Ethics Committee (49/Sper/19).
Informed consent statement: Informed consent was obtained from all the subjects involved in the study.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement: The dataset generated from this study is available upon request to the corresponding author at
nicola.lamberti@unife.it.
STROBE statement: The authors have read the STROBE statement - checklist of items, and the manuscript was prepared and revised according to the STROBE statement - checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4. 0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Nicola Lamberti, BSc, MSc, PhD, Associate Professor, Department of Neuroscience and Rehabilitation, University of Ferrara, Via Luigi Borsari 46, Ferrara 44121, Emilia-Romagna, Italy.
nicola.lamberti@unife.it
Received: April 30, 2024
Revised: June 3, 2024
Accepted: June 25, 2024
Published online: December 18, 2024
Processing time: 142 Days and 21.5 Hours
BACKGROUND
Although the benefits of exercise for kidney transplant recipients (KTRs) have been widely demonstrated, these patients experience several barriers in undertaking a structured exercise program in hospital and non-hospital facilities.
AIM
To compare the effects of a supervised moderate-intensity gym-based intervention with a home-based low-intensity walking program on exercise capacity in KTRs.
METHODS
KTRs were asked to choose between two six-month programs. The first group performed a low-intensity interval walking intervention at home-based exercise intervention (HBex). The second group performed a supervised training program at an adapted physical activity gym (Sgym), including aerobic and resistance training. The outcomes, collected at baseline and at the end of the programs, included the 6-minute walking test, the peak oxygen consumption (VO2peak) during a treadmill test, the 5-time sit-to-stand test, and blood pressure.
RESULTS
Seventeen patients agreed to participate and self-selected into the HBex (n = 9) and Sgym (n = 8) groups. Two patients in the Sgym group dropped out because of familial problems. At baseline, patients in the HBex group were significantly older and had lower walking distance, VO2peak, and lower limb strength. Primary outcome changes were significantly greater in the HBex group than in the Sgym group (52 ± 23 m vs 8 ± 34; P = 0.005). No other significant differences between groups were observed. Both groups improved most of the outcomes in the within-group comparisons, with significant variations in VO2 peak.
CONCLUSION
Six-month moderate-intensity supervised or low-intensity home-based training programs effectively improved exercise capacity in KTRs. Gym-based programs combine aerobic and resistance training; however, in-home walking may be proposed for frail KTRs.
Core Tip: This nonrandomized pragmatic pilot study highlights the significance of implementing structured exercise programs in kidney transplant recipients (KTRs). This study, for the first time, provided the possibility of choosing the preferred training strategy for patients. This fact led to high adherence to the programs and superimposable results in terms of exercise capacity. Home-based low-intensity programs may be a useful option for more deconditioned KTRs.
