Search

Background: Selecting suitable exercise goals is crucial for fostering adherence to, and maintenance of, exercise therapy. We aimed to evaluate the variance in exercise objectives between individuals who continued and those who dropped out of a 6-month intradialytic exercise program by analyzing an open-ended questionnaire administered to patients undergoing hemodialysis. Methods: The study consisted of outpatients (n= 541; mean age, 70 years) undergoing maintenance hemodialysis, who had been informed of an intradialytic exercise program and voluntarily agreed to participate. The primary outcome was the exercise purpose. The difference in exercise purpose was quantitatively analyzed between the exercise continuation and dropout groups. A co-occurrence network was created and concepts were constructed. The basic attributes were compared using chi-squared and independent t-tests. Results: Over 6 months, 154 patients (28.5%) dropped out of the intradialytic exercise program. Concepts related to the goals of the program were: (1) physical function and condition, (2) addressing limitations, (3) maintaining daily life activities, and (4) physical condition recognition. Co-occurrence network analysis showed that the exercise continuation group established their objectives based on the health benefits of exercise, and proactively set goals rooted in comprehending their current issues and problems. The dropout group tended to perceive treatment passively as an extension of daily clinical practice, rather than actively formulating exercise objectives. Conclusion: The exercise objectives of those who continued the exercise program differed from those who dropped out. Patients in the exercise continuation group set more affirmative and specific exercise objectives, whereas those in the dropout group set more passive and abstract exercise objectives. Graphical abstract:

Background: Exercising requires continuing training and maintenance of motivation. Support for exercise continuation by setting sex-appropriate goals is needed. However, this has not been investigated in patients undergoing hemodialysis. This study aimed to investigate sex differences in exercise motivation by analyzing an open-ended questionnaire of patients undergoing hemodialysis. Methods: This multicenter, cross-sectional study was conducted among participants undergoing outpatient hemodialysis at 21 dialysis clinics. Before the intradialytic exercise program, a self-reported questionnaire was used to assess exercise purpose using open-label questions. Exercise purpose was analyzed between sexes by quantitative analysis of text, extracting frequently occurring words, creating a co-occurrence network, and constructing concepts. The basic attributes of the two groups were compared using the chi-squared and independent ttests. Results: The analysis of 669 participants who attended an exercise program showed that the common words for exercise purpose in both sexes were strength, maintenance, walking, exercise, and muscle strength. Significant differences were observed in exercise purpose. Concepts related to the purpose of exercise were categorized into (1) physical function and condition, (2) addressing limitations, and (3) maintaining daily life activities. Physical appearance was important in both sexes. The main purpose of exercise for men was to increase physical fitness and muscle strength, while that for women was to maintain or improve their current functional status and prevent limb weakness. Women had significantly weaker muscle strength and poorer exercise habits than men and had more difficulty in daily life, suggesting that their purpose for exercise was to reduce difficulties in daily life and the burden on family. Women had significantly weaker muscle strength and poorer exercise habits than men and had more difficulty in daily life, suggesting that their purpose for exercise was to reduce difficulties in daily life and the burden on family. Furthermore, fear of falls was higher in women and prevention of falls may be a key for motivation. Conclusion: Exercise purpose in patients undergoing hemodialysis was summarized into the categories of physical function and condition, exercise, and daily life. Men aimed to maintain and increase their current physical status, and women aimed to reduce anxiety regarding their lower limbs and lack of exercise. It is necessary to consider sex differences in exercise purpose when designing exercise regimens and motivating participants. Graphical abstract:

In general, as the size of the problem or the number of objectives to be optimised increases in multi-objective optimisation problems, the distribution range of the Pareto optimal solution set in the search space expands. Expanding the search space makes it difficult for the variable information of other solutions to contribute to generating new solutions. This study proposes a multi-objective quantum-inspired evolutionary algorithm based on isolation strategy (MQEA/I) and a novel lookup table of rotation angle for updating the probability amplitude. In MQEA/I, each individual basically evolves in isolation using the personal best solution and can automatically shift from global search to local search. MQEA/I has only one parameter, the rotation angle, except for the population size and the termination condition. Our experimental results using multi-objective 0-1 knapsack problems show that MQEA/I obtained a more accurate non-dominated solution set than NSGA-II and SPEA2 in problems with many objectives and items.

The quantum-inspired evolutionary algorithm (QEA) and QEA with a pair-swap strategy (QEAPS), where each gene is represented by a quantum bit (qubit) and the qubit is updated by a unitary transformation in both algorithms. QEA and QEAPS can automatically shift the evolution from a global search to a local search and have shown superior search performance to the classical genetic algorithm. However, the population gets into a locally optimal solution and the solution search stagnates when the probability amplitudes of qubit excessively converge to |0› or |1›. In this study, we have proposed a measure that can confirm convergence state of qubits. From the results of the computational experiment in the maximum cut problem, we have clarified that the proposed measure can estimate the state of the qubit, and the quality of the obtained solution is improved by applying the method for maintenance of diversity.

Intradialytic exercise improves physical function. However, malnutrition may be an essential factor affecting the effectiveness of exercise to improve physical function. Few studies of the relationship between malnutrition and the effectiveness of intradialytic exercise to improve physical function exist. Therefore, this study investigated malnutrition at the beginning of intradialytic exercise and how it affects the subsequent improvement in physical function.