The perception of people with chronic kidney disease towards exercise and physical activity: a literature review

Background Promoting exercise and physical activity is crucial to people with chronic kidney disease (CKD). This review aims to identify patients' perceived barriers and motivators to facilitate exercise participation. Method English language, peer-reviewed papers published electronically between January 2000 and October 2018 were considered for review. Patients with chronic kidney failure aged 18 years or older were included, but those with acute kidney injury were excluded. Results People with CKD viewed exercise or physical activity as beneficial and believed in their capability of participation. Fatigue, lack of motivation and safety issues were the main barriers identified, whereas internal drive of health improvement or self-efficacy promotion, and the support from family, friends, peers or the healthcare professional were the commonly reported motivators. Conclusion People with CKD want to maintain physical function and understand the importance of exercise. A multidisciplinary team approach is therefore required to maintain effective exercise programmes that promote physical function. Staffing issues and workload need to be evaluated to incorporate an exercise promotion programme into routine clinical practice. Furthermore, involving patients, family and friends in the development of an exercise promotion programme is crucial to ensure both effectiveness and sustainability. Additionally, it was determined that the elderly and those people with less confidence or low self-esteem will need more encouragement and support to promote participation. In summary, an intradialytic exercise (IDE) programme may be possible but needs further research to address its safety issues, and must include the use of technology to provide ongoing support.