Impact of COVID-19 Pandemic on Health-Related Quality of Life and Physical Activity of Patients in Hemodialysis

Chronic dialysis patients have an increased risk of severe COVID-19 infection-related complications. The aim of this study was to quantify the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and physical activity levels of patients undertaking hemodialysis (HD). This was an observational study that compared data from two periods of time, before the COVID-19 pandemic vs pandemic. We used the Medical Outcomes Survey Short Form (SF-36) to measure the HRQoL and the Human Activity Profile (HAP) questionnaire was used to measure the physical activity. Data were analyzed with a mixed ordinal linear regression. A total of 27 eligible participants were interviewed during COVID-19 pandemic (median age 78 years). The linear regression model showed that the pandemic, after controlling for the covariates age, comorbidity, albumin, and hemoglobin, had a significant impact on the HRQoL. Physical function (−15.7) and social functioning subscales (−28.0) worsened (p = 0.001), and the physical component scale also showed a significant decrease (−3.6; p = 0.05). Time had a significant impact on the Human Activity Profile, with an average activity score diminished with the pandemic (−13.9; p = 0.003). The COVID-19 pandemic had a very negative impact on HRQoL and physical activity level of subjects undertaking hemodialysis. Interventions to improve HRQoL and activity levels of patients undertaking HD are recommended

Hemodynamic tolerance of exercise with virtual reality performed during the first versus the second part of the hemodialysis session

Background and Aims It is recommended intradialysis exercise implementation in the first part of the HD session to avoid hemodynamic instability or cramping, but the time restriction to exercise worsens clinical feasibility of exercise as a routine. Exercise using non-immersive virtual reality is a novel rehabilitation method for patients undergoing hemodialysis treatment. This method has shown in a pilot study improved physical function and health-related quality of life. Objective: to determine effect of exercise with virtual reality during the first two hours and the last two hours of dialysis session on hemodynamic control. Method The design was a randomized clinical trial. Patients were randomized to exercise in the first (Start group) or last two hours (End group) of dialysis session. Intradialysis exercise consisted of a video game adapted to dialysis: Treasure hunting. It is a non-immersive virtual reality game in which the patient must catch some objectives avoiding obstacles by moving the lower limbs. The exercise session lasted from 20 to 40 minutes. Intensity was checked through the rate of perceived exertion. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), episodes of hypotension and episodes of clinical instability are monitored throughout the session. The intervention has already begun and will continue for twelve months. The control analysis is performed during the three months at rest prior to starting the intervention (Rest) and then the intervention begins, every three months. Now we present the results at thirth month with exercise (Exercise) . An mixed ANOVA of repeated measures is used to assess the effect of the intervention. Results 43 patients participated, 11 dropouts, 17 in Start group and 15 in End group. Mean age 73 years, males 28. The mean baseline (SD) was Body Mass Index 26.2 (5.5) kg/m2, Overhydration 2.1 (1.3) liters, Kt/V was 1.65 (SD 0.21), Serum Albumin 3.84 (0.29) mg/dl and Hemoglobin 11.81(1.27) g/dl . Analysis by time Rest versus Exercise showed as mean (SD): HR 64 (8) vs 64 (7) bpm, SBP 143 (18) vs 141 (18) mmHg and DBP 61 (10) vs 60 (11) mmHg, no significant differences. The change in measurements at the end of dialysis showed in Rest vs Exercise were HR – 1.34 (5.7) vs -0.9 (5.9) bpm, SBP 1.2 (12) vs 2.65 (16) mmHg and DBP 2.65 (5.8) vs 1.09 (7.1) mmHg, no significant differences. Analysis by groups Start versus End showed as means (CI95%): HR 66 (62,69) vs 63 (59,67) bpm, SBP 145 (136,154) vs 136 (126,146) mmHg and DBP 63 (58,68) vs 56 (50,62) mmHg, no significant differences. The change in measurements at the end of dialysis showed in Start group vs End group neither showed significant differences. There were no differences between the groups regarding episodes of hypotension or clinical instability. Conclusion Performing intradialysis with virtual reality is well tolerated at any time during the session. This result improves the opportunities to implement exercise in hemodialysis.Sin financiación5.992 JCR (2020) Q1, 3/25 Transplantation1.654 SJR (2020) Q1, 211/2446 Medicine (miscellaneous)No data IDR 2020UE

SO067 Virtual reality exercise intradialysis impact onphysical function and physical activity level: Randomized controlled trial with follow-up

Sin financiación5.992 JCR (2020) Q1, 3/25 Transplantation1.654 SJR (2020) Q1, 7/66 NephrologyNo data IDRUE

P0959 Effect On The Dialysis Dose Of The Exercise With Virtual Reality During The First Versus Second Part Of The Dialysis Session

Sin financiación5.992 JCR (2020) Q1, 3/25 TransplantationUE