#4311 DEVELOPMENT OF A HOME DIALYSIS PATIENT SUPPORT SYSTEM WITH EXERCISE FUNCTION PART II: RESULTS OF A TRIAL OF ADDED EXERCISE FUNCTION
Authors: Okawa Akiko , Yamamoto Natsumi , Sekine Yuki , Umeda Tokuo 
Published: June 2023

Abstract

Background and Aims
In Japan, peritoneal dialysis patients are required to record daily dialysis information in continuous ambulatory peritoneal dialysis (CAPD) notes. However, as the CAPD notes are a list of numbers, it is difficult for medical staff to quickly understand the patient's physical condition. Although many people now use communications infrastructure, access to medical information on the Internet is restricted from the viewpoint of patient information security in medical institutions in Japan. Therefore, patient information outside the medical institution cannot be viewed on the system inside the medical institution. Therefore, we are developing a safe and secure dialysis support system to connect dialysis patients’ homes and medical institutions. We have developed a dialysis support system that can share the patient's vital data, dialysis records, meal records, etc., between patients and medical institutions. Here, we added a function to support the exercise of dialysis patients, and present the results of a trial.

Method
The display and recording items of the previously developed system include vital data, and exchange start time as records necessary for peritoneal dialysis, dialysate concentration, drainage volume, fluid injection volume, drainage volume, drainage time, drainage confirmation, blood pressure, and blood sugar level. In addition to these items, we have added a new function to the system that can automatically input the patient's exercise records from ergo-storage device. This added functionality links movement information from the ergo-storage device with relevant patient information in the previously developed system. It also enables medical staff to view and share the graphical data as visible information from within the facility. The patients exercise using the developed ergo-storage device, and the amount of exercise is stored in the charger. Patients can exercise with this ergo-storage device on both dialysis and non-dialysis days.

Results
To prevent erroneous input, the dialysis records could be entered automatically or selected using radio buttons. In addition, when confirming drainage, it was possible to transmit images to medical institutions. In the added exercise function, the strength of pedaling on the ergo-storage device, the number of rotations, etc., could be output in CSV format. The amount of exercise was sent to the previously developed system. In addition, the system allowed storage of the electricity generated by rotating the pedals in the storage device. This added exercise function encouraged and sustained exercise in dialysis patients. It not only supported the patient's exercise, but also encouraged continuation by compensation for the amount of exercise via storage of electricity to charge devices. Therefore, the patients were motivated not only to exercise but also to continue to exercise. The accumulation of exercise data enabled the patients to understand changes over time, leading to self-management. Furthermore, exercise could be continued even on non-dialysis days. Medical institutions could also share not only the patient's dialysis records, but also information on their amount of exercise, leading to improved patient care.

Conclusion
This developed system with new exercise function supported patients’ exercise and its continuation on both dialysis and non-dialysis days. The amount of exercise by the patient was stored as electricity, which could be used to charge the patient's cell phone, etc. This increased the patients’ motivation to exercise. Furthermore, this information can be shared with medical institutions. This research was supported in part by Gakushin Kaken (JP20H03982).