A/Prof Paul Bennett⢠AnnMarie Corradini ⢠Cherene Ockerby ⢠Tania Cossich. People requiring ... Jackson WT, Taylor RE, Palmatier AD, Elliott. TR, Elliott JL.
Patient Empowerment
Exercise during hemodialysis: The Intradialytic Zumba Gold A/Prof Paul Bennett• AnnMarie Corradini • Cherene Ockerby • Tania Cossich
People requiring dialysis have a lower exercise capacity than the non-ESRD population. Lower exercise capacity is associated with deconditioning, which leads to a reduced quality of life and increased risk of injury.1 Low-impact exercise programs during dialysis have been found to be safe and beneficial for this group.2 In addition, intradialytic exercise can alleviate the boredom of receiving dialysis, creating an exercise-focused positive environment in the dialysis center.3 Increased physical activity may influence people’s physical function and confidence, which may further encourage patient empowerment. A popular exercise program designed for people with physical limitations and inactive older people is Zumba Gold. This is a program in which the Latin and international dance rhythms created in the original Zumba program4 are adapted for older populations.5 We explored the feasibility of implementing a modified Zumba Gold program for patients in one community dialysis unit in Australia.
the exercises included various shoulder, arm, and leg movements, including shoulder squeezes, arm lifts, knee lifts, and toe taps. Results Following the program, a survey was undertaken to measure participants’ satisfaction with the program. All four participants “agreed” or “strongly agreed” that the exercises were easy to do, fun, enjoyable, easy to keep up with, and relieved boredom during treatment, and that the instructor was easy to follow and supportive. Three of the four participants felt happier and more energetic after the exercises, and felt better for having done them, would recommend them to others, and would be interested in
Material and methods Two male and two female patients volunteered for the study. Participants’ were aged 52 – 80 years, their renal diseases were secondary to diabetes, glomerulonephritis, or sepsis, and co-morbidities included chronic vascular disease, ischemic heart disease and chronic obstructive pulmonary disease. All participants had access via an arteriovenous fistula, three on the left side, and one on the right, and all were deemed physically suitable to participate by the renal specialist. Prior to commencing, the registered Zumba Gold instructor met with clinical and research staff to view people receiving dialysis in the unit. Exercises were adapted to suit the needs of participants and could be easily adjusted to suit individual needs. The sessions started 30 minutes into hemodialysis treatment. The instructor guided the four participants together through the exercise program. Participants were constantly engaged with the instructor and clinical staff who could quickly assess and detect any adverse changes in participants’ condition. Twenty, 30-minute sessions were completed by the four patients over a two week period. Choreographed to music, The authors are with the Deakin-Southern Nursing Research Centre, Melbourne, Australia
An instructor leads a class at the dialysis clinic in Australia. Subscribe to our free eNewsletter at www.NephrologyNews.com
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patient empowerment, quality of life, biochemistry parameters and physical function using a larger number of participants is recommended. References 1. Painter P, Moore G, Carlson L, Paul S, Myll J, Phillips W & Haskell W (2002). Effects of exercise training plus normalization of haemotocrit on exercise capacity and healthrelated quality of life. American Journal of Kidney Diseases 39, 257-265 2. Fadem S (2011). Keeping fit: Why dialysis patients should exercise. Available at: http:// www.aakp.org/print-version/dsp_library_ art.cfm?art=278 (accessed 12 May 2012) 3. Stivers A (1996). How an exercise program can benefit patients and the dialysis facility.
Patients participating in the Zumba class.
ously participated in the exercises.
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have used for the past 15 years—“An illness is too demanding if you don’t have hope”—highlights our personal experience that hope is a vital component of the ability to live and thrive with CKD and that support groups play a vital role in this effort.
life. These results showed that hope is a significant predictor of a patient’s adjustment to CKD.5 Conclusion The research confirming the vital role that hope plays in improving patient outcomes is not surprising to those of us who live with CKD. RSN was founded on the principle that “one friend can make a difference” and the conviction that people with CKD can help one another find the support and empowerment necessary to take charge of the course and management of their disease. The tagline that we
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continuing during future treatments. In the first session an arterial alarm was triggered for one patient that was quickly resolved by a position change. Apart from this, there were no adverse events noted during the exercises and the activities did not interfere with the treatments or functioning of the unit. Participants became increasingly active and engaged as the sessions progressed, and the instructor adjusted movements accordingly. Several staff and other dialysis patients spontane-
4. Davidson J and Emberly A (2012). Embodied Musical Communication Across Cultures:
Conclusion This study has found that an intradialytic, modified form of Zumba Gold is a safe and feasible option for people receiving hemodialysis. The intervention was acceptable to patients, was cheap, and did not adversely impact on the hemodialysis treatment. It was fun and encouraged staff and other patients to join the exercises. Further research to determine the impact on
Singing and Dancing for Quality of life and Wellbeing Benefit In Music, Health and Wellbeing (MacDonald R, Kreutz G and Mitchell L eds.). Oxford University Press, Oxford 5. MVP Healthcare (2009) Living Well. Available at:
http://www.mvphealthcare.com/
medicare/2011docs/goldNewsletter_spring_ sdy.pdf (accessed 2012)
matched controls. Child Health Care 27:1530, 1998 3. Elliott TR, Witty TE, Herrick S, Hoffman JT. Negotiating reality after physical loss: hope, depression, and disability. J Pers Soc Psychol 61:608-613, 1991 4. Jackson WT, Taylor RE, Palmatier AD, Elliott TR, Elliott JL. Negotiating the reality of visual
References 1. Affleck G, Tennen H. Construing benefits from adversity: adaptational significance and dispositional underpinnings. J Pers 64:899-922, 1996 2. Barnum DD, Snyder C, Rapoff MA, Mani MM, Thompson R. Hope and social support in
impairment: hope, coping and functional ability. J Clin Psychol Med Settings 5:173185, 1998 5. Billington E, Simpson J, Unwin J, Bray D, Giles D. Does hope predict adjustment to end-stage renal failure and consequent dialysis? Br J Health Psychol 13:683-699, 2008
the psychological adjustment of children who have survived burn injuries and their
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