Physical activity and exercise programs for kidney patients: an Italian survey of nephrology centres
Francesca Bulighin, Filippo Aucella, Vincenzo Bellizzi, Adamasco Cupisti, Teresa Faga, Giovanni Gambaro, Giuseppe Regolisti, Alda Storari, Alessandro Capitanini, Yuri Battaglia, On behalf of Working Group of Physical Exercise of Italian Society of Nephrology, Marco Leoni, Massimo Manes, Lorena Traversari, Alessandra Collosi, Paolo Lentini, Antonino Previti, Valentina Fanny Leone, Luigi Vernaglione, Giuseppe Leonardi, Alessandra Dalla Gassa, Michele Andreucci, Lorenzo Diliberato, Gemma Patella, R. Piperno, Mario Renato Rapanà, Maria Angela Campolo, Luca Piscitani, G Splendiani, Paolo Ria, M. Parrini, Mauro Dugo, Giuseppe Vezzoli, Monique Buskermolen, Gaetano Alfano, Laila Qassim, Maria Amicone, Ersilia Satta, Giancarlo Marinelli, Gabriele Guglielmetti, Carlo Massara, Giuseppe Scaparrotta, Leonardo Calandra, Massimiliano Tosto, Riccardo Maria Fagugli, Federica Baciga, Roberto Scarpioni, Antonio Barillà, Elisa Giglio, Andrea Buscaroli, Francesca Mallamaci, Danio Somenzi, Antonio Favarò, Fulvio Fiorini, Alessandro Naticchia, Sandra Papalini, Veronica Baglio, Sandra La Rosa, Stefano Cenerelli, Marco Amidone, David Micarelli, Marco Pozzato, Fabrizio Valente, Monica Rizzolo, Francesco Bianco, Chiara Caletti, Antonietta Gazo, Paolo Albrizio
Abstract
BACKGROUND: Data on exercise activities in place, and on the interest for developing them in Nephrology Services in Italy is limited. To address this gap, we carried out this cross-sectional study to investigate the status of physical activity and exercise programs available in Italian Nephrology Centres. Additionally, research priorities on this topic were examined. METHODS: We developed a 14-item electronic survey, which consisted of multiple-choice questions covering exercise training programs, physical assessment, barriers to exercise practice and to exercise programs, exercise and physical activity counselling practices, perceived exercise benefits, literature evidence, and research priorities. Data on the characteristics of the centres were also collected. RESULTS: Sixty-two responses from Italian nephrology centres were collected. Ninety-three percent of the respondents were aware of the scientific evidence supporting the benefits of regular exercise programs for chronic kidney disease (CKD) patients. Additionally, in 75% of centres the nephrologists believed that physical activity counselling should be performed by the nephrologists. However, only 26% of centres provided exercise programs, mainly for dialysis patients, and 63% never or infrequently assessed physical activity in the context of patient management. Eighty-nine percent of centres reported barriers to implementing exercise programs, including lack of funding, institutional disinterest, patient refusal, and negative attitudes of the healthcare personnel. Forty-six research priorities related to exercise in CKD patients were suggested, with the majority focusing on impact of exercise programs and physical activity on cardiovascular, nutritional, and psychosocial outcomes. CONCLUSION: This survey highlights the limited availability of exercise programs and physical activity evaluation in clinical practice in Italian Nephrology Centres. However, the survey also revealed a strong interest for counselling CKD patients on physical activity and implementing exercise prescriptions and interventions.