Virtual home-based physical pre-habilitation in kidney transplant candidates: a pilot RCT
In Partnership with Can-SOLVE CKD
Lay Abstract
Individuals awaiting kidney transplantation experience physical problems, are commonly weak and at risk for having poor health before and after transplantation. An exercise program that is offered before transplant is called ‘pre-habilitation” and is recognized as a treatment that can physically prepare surgical patients to the upcoming physiologic stressor (surgery) and help with the recovery after transplant. There is limited research evidence for the effects of pre-habilitation in kidney transplant candidates. Programs that are offered at hospitals are expensive, may not be the optimal way to offer to candidates as they may not be waiting for their transplant in the same city as the transplant centres. Technology tools (e.g. video conferencing) have the potential to improve acceptance and participation in the exercise training. Our proposed research is a pilot study which will evaluate if it is viable to conduct a multicenter study investigating the effects of a virtual home-based pre-habilitation program for individuals awaiting kidney transplantation.
We will recruit participants from three hospitals in Canada: McGill University Health Centre, Centre hospitalier de l'Université de Montréal and University of Alberta Hospital. Participants will be divided into two groups. One group will receive a 12-week home-based virtual prerehabilitation program consisted of exercises that improves the function of the heart, lungs and muscles plus usual care. The other group will receive usual care which will include medical visits, nutritional and psychological support by the transplant programs or dialysis centers. A pilot study is critical to test the processes of implementing our protocol and how acceptable our intervention is for patients. The results of this pilot work will help us design a larger study in the future that will provide us with more definitive results about the effectiveness of the pre-habilitation program. If our intervention is proven effective in a future multicenter study, it will optimize the physical health and quality of life of kidney transplant candidates and their recovery post-transplant. It may also ultimately contribute to reduced healthcare cost post-transplant.
