Kidney BEAM
fistula
KIDNEY
The development and pilot testing of Kidney BEAM is described in detail elsewhere [Kidney BEAM was rapidly co-designed in response to the COVID-19 pandemic. The intervention is guided by the Behaviour Change Wheel and the Behaviour Change Taxonomy [Kidney BEAM is currently free at the point of access in any setting or context, using a personal computer, tablet or smartphone. Participants were prompted to create a personal account through which they could book live classes, bookmark favourite components and track their online and offline physical activity. Participants could use Kidney BEAM The ‘live’ sessions, and on-demand renal rehabilitation programme, were provided by the team at Kings College Hospital, London to all participants nationally as a rolling 12-week programme. Each session included a 10 min warm-up and cool-down consisting of general upper and lower limb mobility and stretching. Each session also provided 20–30 min of aerobic and resistance exercise training, which was delivered in standing and in a seated position so that people from different ability levels could participate. Modifications for fistula and fluid management were offered in each session. Hand and ankle weights, and the use of available home equipment such as filled water bottles and tins of food were suggested to progress resistance exercises. Additionally, 15 min of disease-specific education was offered weekly (see Supplementary Material Each participant was also encouraged to accumulate 150 min/week of moderate intensity aerobic activity or 75 min/week of vigorous activity, and to complete muscle resistance training on two days of the week [Participants were able to undertake these activities at any time that was convenient to them and their lifestyles, although ‘live’ classes were only available four times a week. Use of the DHI was monitored by the team at KCH, and participants prompted via phone or email on a weekly basis. These strategies were selected because they could easily be implemented within a real-world setting. Participants were also able to contact the team in the case of any technical or navigation issues using the Kidney BEAM website.