Exercise as it relates to Disease/The relationship between dog ownership, physical activity and chronic hemodialysis

This is an analysis of the journal article "Dog ownership status and self-assessed health, life-style and habitual physical activity in chronic hemodialysis patients" by Kuban, Krolikowski & Nowicki (2016).

What is the background to this research?
Chronic kidney disease (CKD) is the loss of kidney regulatory and excretory function, categorised into 5 stages based on the level of kidney function or damage. There is approximately 8-16% of the adult population worldwide in stages 3–5 of CKD, with stage 5 including those who are at risk of commencing chronic hemodialysis.

Research reviewing the advantages and disadvantages of physical activity for individuals with CKD have shown that, with the right prescription and intensity, exercise can be of benefit to quality of life. Other studies have also found that there can be a greater frequency of physical activity in patients with a chronic disease who own a dog, when compared to individuals in similar circumstances but who do not own or walk a dog.

This means that dog ownership and physical exercise may be important factors towards the fight against CKD in patients undertaking chronic hemodialysis.

Where is the research from?
The three authors are from the Department of Nephrology, Hypertension and Kidney Transplantation, at the Medical University of Lodz in Poland. Research was conducted within seven dialysis clinics across central Poland.

What kind of research was this?
This is a cross-sectional study. To the authors’ knowledge this is the first research that considers the benefit of dog ownership in chronic hemodialysis patients.

What did the research involve?
The research involved a population of 270 chronic hemodialysis patients, which included 116 dog owners. Participants completed a questionnaire, made up of 38 questions relating to chronic hemodialysis physical activity levels, as well as physical inactivity variables, such as:
 * duration of hemodialysis;
 * pet ownership status;
 * amount of time spent each day walking; and
 * frequency of other sports.

All responses were anonymously provided to the authors.

This form of questionnaire could perhaps benefit from the researchers directly interviewing the patients, to avoid any misinterpretations of the questions and to be there to explain any arising queries. This could also assist in preventing individuals in under or over self-reporting. However this would also remove the anonymity, which may reduce the number of participants.

What were the basic results?
From the chronic hemodialysis patients who own a dog, 73% indicated they regularly go for walks, while only 64% of non-dog owners indicated the same. Interestingly, the study also recorded participation in other sports as higher in dog owners. Therefore, from this chosen population dog ownership does appear to involve more frequent participation in many varieties of physical activity. The authors suggest that this could be due to dog owners being younger.

In the Discussion, the authors recognise that dog ownership does not always positivity influence an individual to undertake higher levels of physical activity.

What conclusions can we take from this research?
The results of the present study correlate dog ownership to physical activity in chronic hemodialysis. This is similar to previous studies that have correlated dog ownership and physical activity within other chronic disease patients. Therefore owning a dog could be a positive factor towards increasing physical activity levels in CKD patients. It would now be beneficial to solve how to motivate those patients who are not as active. If we knew this information, we could use the findings as an opportunity to potentially improve quality of life in all CKD patients.

Practical advice
Owning a dog has its benefits, however it may not be an economical or lifestyle possibility for all CKD patients. Perhaps if there is a friend or a neighbour who owns a dog, or even another walkable pet, they could borrow them for a couple of hours. Another idea could be to reach out as a volunteer to a program that involves walking pets.

Consideration may also be needed when looking at this population, as the research does not provide solid reasoning behind sedentary behaviour. Whether this is due to reactions from the hemodialysis or other individual factors could be a deciding factor in preventing those individuals from completing physical activity on all occasions.

Further information/resources
Further information on CKD can be found at http://www.aihw.gov.au/chronic-kidney-disease/. There is an exhaustive choice of dog walking volunteer programs within Australia. These include (but not limited to):
 * Dogs’ homes of Tasmania – http://dogshomesoftas.com.au/about/volunteering/
 * Domestic Animal Services – http://www.tccs.act.gov.au/about-us/volunteers
 * RSPCA – http://www.volunteering.nsw.gov.au/volunteers/volunteers-stories/rspca
 * Therapeutic Dog Services Inc – http://www.therapeuticdogservices.com/volunteer
 * Victoria Police Puppy Walking Program – http://www.police.vic.gov.au/content.asp?Document_ID=19508