Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Effects of a Nurse-led Case Management Programme on Home Exercise Training for Haemodialysis Patients
Brief Summary: The purpose of this study is to examine the effects of a nurse-led case management programme on home exercise training for haemodialysis patients. We hypothesised that: a. There is no significant difference in physical functioning between participants receiving the nurse-led home exercise training programme and those receiving the comparison care. b. There is no difference in depression between participants receiving the nurse-led home exercise training programme and those receiving the comparison care. c. There is no difference in quality of life and health perception between participants receiving the nurse-led home exercise training programme and those receiving the comparison care. d. There is no difference in physical activity levels between participants receiving the nurse-led home exercise training programme and those receiving the comparison care. e. There is no difference in perceived benefits and barriers of exercise between participants receiving the nurse-led home exercise training programme and those receiving the comparison care.

The study was a randomized controlled trial conducted in two haemodialysis units of two tertiary hospitals in Nanjing, China. Participants were randomly assigned to either study group or comparison group. Participants in both groups received the in-center exercise training (20 minutes) before haemodialysis sessions weekly for 6 weeks and were instructed to perform exercise at home. The in-center training was focused on flexibility and strengthening exercise. Patients were encouraged to have cardiovascular exercises at home which will improve their cardiovascular conditions and endurance. The list of cardiovascular exercise included brisk walking, bicycling, jogging. Participants in the study group were instructed to start walking or brisk walking at low duration and gradually progress to a maximum of 30 minutes daily per week. To facilitate exercise progression, the nurse case managers discussed exercise benefits, explored exercise barriers and developed mutual goals with patients. The nurse motivated them and checked the exercise behaviors to ensure adherence to the recommended exercise regime. The nurse case managers interviewed the study group patients weekly for six weeks and biweekly for another six weeks. Participants in the comparison group only participated in the in-center exercise training. The comparison group patients received usual care from the nurse without the interviews and mutual goals developed.


Options:
A: Inclusion Criteria:

* Clinically stable ESRD patients receiving regular hemodialysis treatment for at least 3 months,
* adequate dialysis delivery Kt/V \>1.1
* good compliance of dialysis treatment
* serum albumin \>2.5 g/dL
* hemoglobin ≥11g/dL.

Exclusion Criteria:

* Patients with a reason to be in a catabolic state,
* hyperthyroidism,
* active vasculitis,
* malignancies,
* pregnancy
* HIV,
* opportunistic infections,
* musculoskeletal contraindication to exercise,
* requirement for systemic anticoagulation,
* participant or participated in an investigational drug or medical device study within 30 days,
* active inflammations, that required intravenous antibiotics within 3 months prior to enrollment,
* diabetics receiving insulin therapy,
* New York Heart Association grade IV heart failure,
* mental incapacity to consent.
B: Inclusion Criteria:

* adult (age ≥18)
* dialysis dependent for ≥ 3 consecutive months
* receiving ≥ 3 dialysis treatments per week
* mobile (any distance and can be with the assistance of an aid)
* at least one non-prosthetic and functional limb
* stable during hemodialysis treatment (assessed by hemodialysis unit staff and the study physician)
* capable of providing consent

Exclusion Criteria:

* currently enrolled in a clinical trial
* missing an average of more than 2 shifts per month
* planned move or modality change within the next 4 months
* currently enrolled in a structured exercise program
* scheduled hospitalization for \> 1 week
* any uncontrolled medical condition that would preclude participation in a low/moderate intensity exercise program (e.g. unstable angina, uncontrolled hypertension, severe valvular heart disease)
C: Inclusion Criteria:

* Adults with end-stage renal disease (stage 5 CKD), who were on a stable in-center hemodialysis regimen (approximately 4 hours 3 times per week) for ≥ 12 weeks prior to recruitment
* A cardiac evaluation was required within the last year to ensure adequate cardiac function

Exclusion Criteria:

* Any physical or psychological disability that would impact study participation, such as severe cerebrovascular disease (e.g., hemiparesis, cerebellar ataxia, etc.) or dementia
* Serum intact parathyroid hormone(iPTH)\>250 pmol/L within 30 days prior to screening visit
* Dysrhythmia or severe cardiac disease, such as congestive heart failure (CHF) Class III-IV, or unstable cardiovascular disease within 90 days prior to recruitment
* Severe peripheral arterial disease
* Severe hyperkalemia (\>6.5 milliequivalent/L) consistently the last 2 weeks
* Current active cancer (excluding basal cell carcinoma of the skin)
* Poorly controlled hypertension (post-dialytic systolic blood pressure ≥ 160mmHg or diastolic blood pressure≥ 100 mmHg) within 4 weeks prior to recruitment
* Anticipated living donor kidney transplant or any other planned major surgery over the study duration
* History of poor treatment adherence
D: Inclusion Criteria:

* Dialysis for \>3 months;
* Age \> 18 years;
* Kt/V (dialysis adequacy) \>1.2;
* Hemoglobin level \> 8g/dl;
* Ambulatory without assistance ;
* Able to communicate in Chinese;
* Able to and willing to provide consent.

Exclusion Criteria:

* Unstable physical conditions or severe musculoskeletal diseases that might hinder exercise training;
* Severe hearing impairment;
* Diagnosed with mental diseases;
* Meeting or exceeding the exercise recommendation.

Answer: D