Effects of transtheoretical model–based physical activity counseling in kidney transplant recipients

Background This study investigated the effects of Transtheoretical Model-based physical activity counseling on physical activity level, physical activity behavior, gait speed, and cardiovascular disease (CVD) risk in kidney transplant recipients (KTRs). Methods Twenty-eight KTRs were assigned to either a physical activity group (n = 14) or a control group (n = 14). The physical activity group participated in a 12-week transtheoretical model-based physical activity counseling that included motivational interviews, patient education, physical activity diaries/booklets, and individualized guidance on adopting and maintaining physical activity. Physical activity level was measured with an accelerometer, while physical activity behavior was assessed by the Exercise Stages of Change Questionnaire. Gait speed was evaluated using a wireless inertial sensor system (G-Walk). CVD risk was predicted using a web-based interactive tool (HeartScore). Assessments were conducted at baseline, and at weeks 12 and 24. Results Baseline number of steps and average metabolic equivalent were higher in the physical activity group (P < .05). At week 12, step count was higher in the physical activity group (P = .004). At week 24, number of steps, average metabolic equivalent, active energy expenditure, and physical activity duration were higher in the physical activity group (P < .05). Number of steps, average metabolic equivalent, active energy expenditure, and physical activity duration did not show any differences within each group (P > .05). Gait speed increased from baseline to the 12th week in the physical activity group (P = .016). At the 12th week, 13 participants were in the action stage and 1 was in the maintenance stage in the physical activity group, whereas in the control group, 3 participants were in the pre-contemplation stage, 2 were in the contemplation stage, and 9 were in the preparation stage (P < .001). There were no significant differences between the groups in HeartScore at any time points (P > .05). Conclusions Transtheoretical model-based physical activity counseling shows potential as a feasible and acceptable approach to promote physical activity behavioral readiness in KTRs, and could help manage cardiovascular risk factors by addressing physical inactivity.