#4310 DEVELOPMENT OF A HOME DIALYSIS PATIENT SUPPORT SYSTEM WITH EXERCISE FUNCTION PART I - SYSTEM DEVELOPMENT AND EVALUATION
Authors: Umeda Tokuo , Okawa Akiko , Yamamoto Natsumi , Sekine Yuki 
Published: June 2023

Abstract

Background and Aims
Although many people use communications infrastructure, direct connection of electronic medical records to the Internet is restricted at medical institutions in Japan. Therefore, patient information outside the medical institution cannot be viewed on systems inside the medical institution. We are developing a safe and secure dialysis support system that connects dialysis patients and medical institutions, which is separate from the system within medical institutions. We have developed a dialysis support system that can share vital data, dialysis records, meal records, etc., between patients and medical institutions.
In this study, to support dialysis patients’ exercise and its continuation, we created an ergo-storage device combining an ergometer and storage device for this research and added functions to the existing dialysis support system. This system with additional exercise function could encourage patients to exercise, store the amount of exercise as the amount of electricity used, this electricity represented a reward to the patient for exercising. These additional features allow the patient to exercise at home on both dialysis and non-dialysis days.

Method
An ergometer was used as exercise equipment for dialysis patients with a hub dynamo to convert the rotations of the ergometer through a belt into electricity. This allowed the dynamo to take over the rotation of the ergometer. In addition, we developed a new circuit that converts the power generated by the dynamo to USB voltage. A simple USB voltage and current checker was added to allow the integrated power to be displayed making it possible to visualize momentum as power generation. In addition, the generated power could be stored in the USB charger.
To record the amount of exercise of the patient, the information from the ergometer was output to a tablet in CSV format. This CSV file was sent to the developed system and linked with the patient information in the existing system. This system made it possible to visualize and display the exercise information along with the patient's daily dialysis information and meal information on the developed system.

Results
Momentum could be converted to electrical energy using the ergo-storage device. The patient could now see and store the amount of exercise they have done, enabling the patient to exercise on both dialysis and non-dialysis days. As the amount of exercise could be visualized at a glance, the patient was encouraged and prompted to exercise daily. In addition, as the amount of exercise could be stored as electricity, this electricity represented a reward to the patient for exercising.
The patients reported that it was good to be able to enjoy exercising instead of having a quota, and that they were able to continue exercising. Patients began exercising voluntarily instead of being forced to exercise by health care workers. In addition, it was possible to link the system with the patient's dialysis records and share the amount of exercise, making it easier for medical professionals to understand the patient's physical condition.

Conclusion
A function that allows dialysis patients to exercise was added to the developed system. Using this system, patients and medical institutions could share dialysis records, such as the patient's amount of exercise. The patients could exercise on both dialysis and non-dialysis days, and the amount of exercise and dialysis records could be shared with medical institutions. In addition, the amount of exercise was stored as electricity, which increased the patient's motivation to exercise. The patients began to exercise voluntarily.
This research was supported in part by Gakushin Kaken (JP20H03982).