S3 L2: Renal Rehabilitation Part 2

Question 1

T/F: Patients receiving continuous ambulatory peritoneal dialysis should be tested without dialysate fluid in their abdomens.

Answer 1

True

Question 2

T/F: HR is always be a reliable indicator of exercise intensity in individuals with kidney diseases

Answer 2

False.

Because HR may not always be a reliable indicator of exercise intensity in individuals with kidney diseases, perceived exertion should always be monitored especially when taking beta blockers (may still depend on the medications that the pt is taking)

Question 3

T/F: Dynamic strength testing should be done using a 3-RM or higher load (e.g., 10–12-RM).

Answer 3

True

Question 4

What is the prescription for stage 1-4 kidney diseases?

Answer 4

Dynamic strength testing should be done using a 3-RM or higher load (e.g., 10–12-RM).

For end-stage renal disease, can prescribe higher RM
(12-15)
■ Higher RM, easier for patients
■ 1-RM → pt carries resistance once only

Question 5

Fill in the blanks:
Muscular strength and endurance may be safely assessed using _____ dynamometry with angular
velocities in the ___°– ____°/s range.

Answer 5

Muscular strength and endurance may be safely assessed using isokinetic dynamometry with angular
velocities in the 60°– 180°/s range.

Question 6

T/F: Isometric dynamometry is okay in renal rehab

Answer 6

False. Avoid isometric since we can induce valsalva which can affect BP

Question 7

T/F: Physical performance tests may be used to test
individuals with kidney disease.

Answer 7

True

Question 8

Give at least two (2) examples of physical performance tests

Answer 8

○ Cardiovascular fitness (e.g., 6-minute walk test)
○ Muscular strength (e.g., sit-to-stand-to-sit test)
○ Balance (e.g., functional reach test)

Question 9

T/F: For patient populations, very rare that we are using
1-RM (or 100%)

Answer 9

True

Question 10

EXERCISE PRESCRIPTION FOR RENAL
REHABILITATION

T/F: The following are included under reccomendation for exercise frequency

1.Aerobic exercise = 3-5 days/wk
2.Resistance = 2-3 days/wk
3. Min (<40%) to moderate (40-60%) HRR
4.RPE6-20 = 12-17
5. Only 75% of 1 RM

Answer 10

1. T
2. T
3. T
4. F. RPE6-20 = 11-16
5. F. 60-75% of 1 RM

Question 11

T/F: It is highly recommended to start with
5 days/wk

Answer 11

T

Question 12

What is the recommended time for aerobic training? How about for resistance?

Answer 12

Aerobic training = 20-60 min/day

Resistance = 10-15 reps/1-3 sets

Question 13

Give me example of types of aerobic and resistance exercises

Answer 13

Aerobic exercise (e.g., walking and
cycling)
○ Targets big muscle groups

Resistance exercise (e.g., PRE using
elastic bands or free weights)

Question 14

Identify which condition has the following special consideration:

Exercises may be prescribed, and it should be based on
individual needs of patients and the disease stage.

Answer 14

NEPHRITIS/NEPHROSIS

Question 15

Identify which condition has the following special consideration:

Lifestyle and dietary guidance should be incorporated in the renal rehabilitation program → interprofessional
collaboration.

Answer 15

NEPHRITIS/NEPHROSIS

Question 16

Identify which condition has the following special consideration:

If a patient is treated with oral steroids, fracture risk
should be taken into consideration.

Answer 16

NEPHRITIS/NEPHROSIS

Question 17

Identify which condition has the following special consideration:

Training should not be done immediately post-dialysis
but may be performed on non-dialysis days.

Answer 17

hemodialysis

Question 18

T/F: In hemodialysis patients,if training is done during dialysis, exercise should be attempted during the second half of the treatment to avoid hypotensive episodes.

Answer 18

F.

If training is done during dialysis, exercise should be
attempted during the FIRST half of the treatment to avoid hypotensive episodes.

Question 19

T/F: In hemodialysis patients, because HR may be an unreliable indicator of exercise intensity, use RPE.

Answer 19

T

Question 20

Identify which condition has the following special consideration:

During periods of rejection, the intensity and time of
exercise should be reduced, but exercise may still be
performed.

Answer 20

KIDNEY/RENAL TRANSPLANT PATIENTS

Question 21

Modified T/F: In renal transplant patients, Exercises are still effective for kidney transplant patients .Exercise group is more effective compared to pilates alone

Answer 21

Both T

Question 22

The following are barriers to exercise participation, EXCEPT:

A. Fatigue & SOB on dialysis and non-dialysis days
B. Lack of motivation
C. Lack of knowledge that exercise is beneficial
D. Lack of clearly defined “best” programs
E. Location of exercise training
F. Additional cost
G. NOTA

Answer 22

G. All are barriers to exercise parrticipation (B and C choices are related)