PHYSIOTHERAPY ASSESSMENT AND INTERVENTION OF FRAILTY IN KIDNEY TRANSPLANT WORK UP
ERICA PATTERSON1, SUZANNAH JACKSON2, CLAIRE BOOTE1, MARLETTE HILES4, BASU GOPAL4, ANGELA BURGE1,3
1Physiotherapy Department, Alfred Health, Melbourne, Australia, 2Dietician Department, Alfred Health, Melbourne, Australia, 3Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia, 4Department of Renal Medicine, Alfred Health, Melbourne, Australia
Aim: To evaluate a targeted physiotherapy intervention for frail adults working towards kidney transplantation (KT).
Background: Frailty is common amongst individuals working towards KT and leads to poorer outcomes, reduced access to KT and increased risk of mortality. Frailty is defined as decreased physical and physiological reserve to respond to stressor events. Prehabilitation including physiotherapy exercise intervention can reduce frailty, better mitigate the effects of frailty, and improve main outcomes post KT.
Methods: Adults attending the Alfred Health Renal Transplant Clinic were identified. Baseline (T1) and three-month (T2) assessments included frailty (Frieds Frailty Phenotype [FFP]) and functional exercise capacity (30-second sit to stand [30STS]). Individuals who had FFP scores of 1-2 (pre-frail) or ≥3 (frail) and 30STS ≤11 (female) and ≤12 (male) underwent twice weekly group exercise using telehealth, or an individualised exercise program supervised by a physiotherapist.
Results: Forty adults attended baseline physiotherapy assessment over 5 months (27 male, mean age 60 [SD 10] years). At T1 FFP scores were 18% (n=7) frail, 48% (n=19) pre-frail and 35% (n=14) not-frail and 30STS mean 10 [SD 7]. Higher FFP was associated with lower 30STS (r=-0.42, p=0.005) and an increase by 1 FFP was associated with reduced 30STS score by 2 (95% CI 4 to 1, p=0.009). At T2 (n=19) prevalence was 11% (n=2) frail, 53% (n=10) pre-frail, and 37% (n=7) not-frail and 30STS mean 11 [SD 5].
Conclusion: Prevalence of frailty reduced, and physical function improved after a three months of targeted physiotherapy intervention in individuals working towards KT. Early identification and intervention of frailty can improve physical function pre-KT. Further assessments are required to understand changes in frailty and physical function.
Biography:
Erica Patterson is a Senior Physiotherapist at Alfred Health (Melbourne, Victoria). Through her clinical work in inpatient kidney transplant, haematology, and oncology she developed a keen interest in the allocation of public health resources to optimise efficiency and efficacy of care delivery and alleviate system burden. In 2023, Erica contributed to the development of a novel Kidney Transplant prehabilitation service, as well as a prehab and rehab service for haematopoietic stem cell transplant recipients. Erica is completing her Master of Public Health at the University of Sydney focusing on development and implementation of evidence informed health policy and service.