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N. Shah1, H. Shah2
1SBB College of Physiotherapy, Physiotherapy, Ahmedabad, India, 2Institute of Kidney Diseases and Research Centre, Physiotherapy Department, Ahmedabad, India
Background: With advancement of surgical expertise, immunosuppression therapy and organ donation awareness; the number of kidney transplantation are steadily rising in India. Regular physical exercise plays a fundamental role in ameliorating adverse effect of lifelong immunosuppression therapy along with the pre-existed dialysis induced physical dysfunction. Current international evidences show that exercise intervention is effective, safe, and feasible in patients with kidney disease, regardless of stage or transplantation status.
Purpose: Because of the complex pathophysiology, unique need, immunocompromised status, staying in remote areas away from transplantation rehabilitation centers; kidney transplant population seek specific consideration for exercise intervention strategies particularly regarding their global management even at home in later phase of transplantation.Due to lack of proper exercise guideline and awareness among kidney transplantation stakeholders, there is vast disparity exist, regarding the form and intensity of exercise that the transplant recipient should perform regularly after successful transplantation surgery. That stress more importance on development and validation of structured home exercises program resource material in local Indian languagesfor these population.
Methods: Structured home exercise program was developed as per guideline suggested by ACSM and based on previous literature on exercise training after renal transplant. The 24 page colour booklet was designed that included exercise illustration with description in Hindi and Gujarati languages. The booklet covered the introduction, outline about the need of exercise after transplant, what care should be taken before starting exercise, how to self-monitor the intensity of exercise and also mentioned about when it is not safe to do exercise. Four type of exercise were illustrated that included flexibility, aerobic, strengthening and pranayama. Information on frequency, intensity, time, type of exercises, warm up and cool-down exercises were mentioned with each exercise.
For the content and feasibility of exercises, the consensus of expert panel including three nephrologist, one transplant coordinator and four physiotherapist (more than 10 years of experience in field) was takenusing the Delphi technique.The validity of booklet was evaluated using a form containing 10 items scored on a 3-point Likert scale, and by qualitative assessment. Concomitantly, five kidney transplantation recipients were invited to evaluate the booklet for its applicability. The frequency of the expert ratings, percentage agreement and content validity index(CVI) was analyzed for each item on the form and the instrument as a whole. Values greater than or equal to 80% considered for validation.
For the content and feasibility of exercises, the consensus of expert panel including three nephrologist, one transplant coordinator and four physiotherapist (more than 10 years of experience in field) was takenusing the Delphi technique.The validity of booklet was evaluated using a form containing 10 items scored on a 3-point Likert scale, and by qualitative assessment. Concomitantly, five kidney transplantation recipients were invited to evaluate the booklet for its applicability. The frequency of the expert ratings, percentage agreement and content validity index(CVI) was analyzed for each item on the form and the instrument as a whole. Values greater than or equal to 80% considered for validation.
Results: The Structured home exercise program booklet underwent 2rounds of revisions from expert groups. The CVI per item and as a whole ranged from 70 to 100% in round one, with all items obtaining 100% in the second round. When assessed by transplantation recipients, 95%consensuswas achieved in a single round.
Conclusions: The Structured home exercise program booklet was validated for use in the population studied.
Implications: The Structured home exercise program booklet can be very useful resource material for kidney transplant recipients who cannot visit the exercises rehabilitation centers regularly. For patients suffering from low immunity status can improve their physical activity level using this booklet at home.
Funding acknowledgements: None
Keywords:
Kidney transplantation
Structured home exercises program
Validation studies
Kidney transplantation
Structured home exercises program
Validation studies
Topics:
Community based rehabilitation
Health promotion & wellbeing/healthy ageing/physical activity
Service delivery/emerging roles
Community based rehabilitation
Health promotion & wellbeing/healthy ageing/physical activity
Service delivery/emerging roles
Did this work require ethics approval? Yes
Institution: IKDRC-ITS, Medicity, Ahmedabad
Committee: Institutional Ethical Committee, IKDRC-ITS
Ethics number: IKDRC‑ITS EC/App/28sep2018/08, CTRI trial registration number 027245, ECR/143/Inst/GJ/2013/RR-19
All authors, affiliations and abstracts have been published as submitted.
