Effect of physical activity and vitamin D compared with vitamin D alone on muscle strength, back flexibility and aerobic activity in patients with chronic kidney disease:A comparative study from Pakistan

Background and Objectives: To compare the differences in musculoskeletal health with vitamin D alone in comparison with vitamin D with physical activity (PA) among chronic kidney disease (CKD) patients. Methodsand Study Design: An open labeled, randomized, controlled trial was conducted at two tertiary care centers inPakistan. Patients with CKD stage 2–4 and vitamin D deficiency (<20 ng/mL) were recruited in the trial. Both thearms were given oral vitamin D (cholecalciferol) drops (4000 IU) once daily for three months. One arm receivedonly vitamin D (VD arm), while the second arm received vitamin D along with PA (VDPA arm). Results: Of the1,235 CKD stage 2-4 subjects contacted, forty-six subjects were enrolled. Eighteen were assigned to VD arm andtwenty-eight were assigned to VDPA arm. Between groups comparison shows that bicep strength increases from15 to 17 kg. Likewise, back flexibility and aerobic fitness also increased among those who receive vitamin D andphysical activity, however these differences were not statistically significant (p>0.05). Sensitivity analysis withingroup comparison shows rise of bicep strength from 13.8 kg to 15.2 kg in the VD alone arm (p=0.05); however,in the VDPA arm, there is a greater difference of 14.3 kg to 17.2 kg (p<0.001). Conclusions: Targeted PA amongCKD patients has potential to improve bicep strength and back flexibility.