JCNRJournal of Clinical and Nursing Research2208-36852208-3693Bio-Byword Scientific Publishing Pty. Ltd.10.26689/jcnr.v10i1.13862ArticleObservation on the Effect of Combined Exercise Intervention Based on the Hospital-Community-Family Model on Intrinsic Capacity in Elderly Patients with Diabetes Mellitus Complicated by Chronic Kidney Disease https://artdesignp.com/journal/JCNR/10/1/10.26689/jcnr.v10i1.13862ZhengMeijie,LiuWenxiu,QuBohan,MengQiong,ChenZiye,ChenJiale,WangYongfeng,LiXian,JiaoHuifeng20261012026-02-11Objective: To explore the application effect of combined exercise intervention based on the hospital-community-family model on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease. Methods: Using convenience sampling, 100 elderly patients with diabetes mellitus complicated by chronic kidney disease who received treatment in the endocrinology department of a tertiary A-level hospital from May 2024 to May 2025 were selected as the study subjects. They were randomly divided into an experimental group (50 cases) and a control group (50 cases) using a random number table method. The control group received routine health education and telephone follow-up, while the experimental group, in addition to the control group’s interventions, underwent combined exercise intervention based on the hospital-community-family model. Remote medical guidance was utilized to monitor and study the application effect of exercise intervention on intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease. Fasting blood glucose, 2-hour postprandial blood glucose, glomerular filtration rate, 6-minute walk distance, and scores in five dimensions of intrinsic capacity (exercise, cognition, psychology, vitality, and sensation) were measured before the intervention, at 4 weeks of intervention, and at 12 weeks of intervention for both groups. Results: Before the exercise intervention, there were no statistically significant differences (p > 0.05) between the two groups in terms of fasting blood glucose, 2-hour postprandial blood glucose, glomerular filtration rate, 6-minute walk distance, and scores across five dimensions of intrinsic capacity: mobility, cognition, psychology, vitality, and sensation. After 12 weeks of intervention, the experimental group demonstrated significantly higher scores than the control group in glomerular filtration rate, 6-minute walk distance, and the dimensions of mobility, cognition, and vitality within intrinsic capacity, with all differences being statistically significant (p < 0.05). Conversely, the experimental group showed significantly lower scores than the control group in fasting blood glucose, 2-hour postprandial blood glucose, and the psychological dimension of intrinsic capacity, with these differences also being statistically significant (p < 0.05). Conclusion: Continuous nursing care utilizing telemedicine based on a hospital-community-family model combined with exercise intervention can effectively enhance exercise tolerance and intrinsic capacity in elderly patients with diabetes mellitus complicated by chronic kidney disease, thereby improving their quality of life. The effectiveness of the intervention is positively correlated with the duration of the intervention.

Yan H, Li L, Xia M, 2025, A Qualitative Study on the Dilemmas in Nursing Management for Elderly Patients with Comorbid Chronic Diseases under the DRG Payment System. Journal of Nursing Science, 40(23): 110–114.

Fu H, Liu S, Bastacky S, et al., 2019, Diabetic Kidney Diseases Revisited: A New Perspective for a New Era. Molecular Metabolism, 30: 250–263.

Martínez-Castelao A, Navarro-González J, Górriz J, et al., 2015, The Concept and Epidemiology of Diabetic Nephropathy Have Undergone Changes in Recent Years. Journal of Clinical Medicine, 4(6): 1207–1216.

Li Y, Ran L, Bai L, et al., 2025, Research Progress on the Decline of Intrinsic Capacity in Older Adults. Nursing Research, 39(24): 4232–4235.

Charles A, Buckinx F, Locquet M, et al., 2020, Prediction of Adverse Outcomes in Nursing Home Residents Based on the Intrinsic Capacity Proposed by the World Health Organization. Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 75(8): 1594–1599.

Antoun J, Brown D, Jones D, et al., 2021, Understanding the Impact of Initial COVID-19 Restrictions on Physical Activity, Wellbeing, and Quality of Life in Shielding Adults with End-Stage Renal Disease in the United Kingdom. International Journal of Environmental Research and Public Health, 18(6): 3144.

Perl J, Karaboyas A, Morgenstern H, et al., 2017, Association between Changes in Quality of Life and Mortality in Hemodialysis Patients: Results from the DOPPS. Nephrology Dialysis Transplantation, 32(3): 521–527.

Stauss M, Floyd L, Becker S, et al., 2020, Opportunities in the Cloud or Pie in the Sky? Current Status and Future Perspectives of Telemedicine in Nephrology. Clinical Kidney Journal, 14(2): 492–506.

Sun K, Ji H, Song F, et al., 2023, Research Progress on the Application of Telemedicine in Patients with Parkinson’s Disease. Nursing Research, 37(5): 860–864.

Ma J, 2018, Opinions of the General Office of the State Council on Promoting the Development of “Internet + Healthcare”. China Government Website.

Cox N, Dal Corso S, Hansen H, et al., 2021, Telerehabilitation for Chronic Respiratory Disease. Cochrane Database of Systematic Reviews, 1(1): CD013040.

Chinese Diabetes Society, Chinese Medical Association, 2021, Guidelines for the Prevention and Treatment of Type 2 Diabetes Mellitus in China. Chinese Journal of Endocrinology and Metabolism, 37(4): 311–398.

Zhu H, Sun L, Chen R, et al., 2018, Observation on the Application Effect of Remote Follow-Up Platform in the Management of Chronic Kidney Disease. Journal of Chronic Diseases, 19(4): 387–390.

National Geriatric Medical Center, Chinese Diabetes Society, Chinese Association of Sports Science, 2024, Guidelines for Exercise Therapy in Type 2 Diabetes Mellitus in China. Chinese Journal of Sports Medicine, 43(6): 419–452.

Hu Y, Wang Z, Chen Z, et al., 2019, Expert Consensus on Exercise Rehabilitation for Adult Patients with Chronic Kidney Disease in China. Chinese Journal of Nephrology, 35(7): 537–543.

Guralnik J, Simonsick E, Ferrucci L, et al., 1994, A Short Physical Performance Battery Assessing Lower Extremity Function: Association with Self-Reported Disability and Prediction of Mortality and Nursing Home Admission. Journal of Gerontology, 49(2): M85–M94.

Folstein M, Folstein S, McHugh P, 1975, Mini-Mental State: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12(3): 189–198.

Rubenstein L, Harker J, Salvà A, et al., 2001, Screening for Undernutrition in Geriatric Clinical Practice: Development of the Short-Form Mini-Nutritional Assessment. Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 56(6): M366–M372.

Sheikh J, 1986, Geriatric Depression Scale: Recent Evidence and Development of a Shorter Version. Clinical Gerontology, 5: 165–173.

Oh W, Cho M, Jung S, et al., 2023, High Levels of Physical Activity Mitigate the Adverse Impact of Prolonged Sedentary Time on the Incidence of Chronic Kidney Disease. Journal of Cachexia, Sarcopenia and Muscle, 14(1): 622–631.

Abdelbasset W, Ibrahim A, Althomali O, et al., 2022, Effect of Twelve-Week Concurrent Aerobic and Resistance Exercise Training on Functional Capacity and Quality of Life in Patients with Chronic Kidney Disease. European Review for Medical and Pharmacological Sciences, 26(17): 6098–6106.

Watson E, Gould D, Wilkinson T, et al., 2018, Twelve-Week Combined Resistance and Aerobic Training Provides Greater Benefits than Aerobic Training Alone in Nondialysis Chronic Kidney Disease. American Journal of Physiology Renal Physiology, 314(6): F1188–F1196.

Zhang F, Wang W, Zhang H, 2022, Interpretation of Clinical Practice Guidelines and Expert Consensus on Exercise Rehabilitation for Chronic Kidney Disease. Chinese Journal of Blood Purification, 21(2): 111–114.

Chen J, Li X, Gao Q, et al., 2023, Effect of Modified Baduanjin Exercise on Fatigue and Quality of Life in Elderly Non-Dialysis Patients with Chronic Kidney Disease. Nursing Practice and Research, 20(2): 235–240.

Yu R, Amuthavalli Thiyagarajan J, Leung J, et al., 2021, Validation of the Construct of Intrinsic Capacity in a Longitudinal Chinese Cohort. Journal of Nutrition Health and Aging, 25(6): 808–815.

Liu S, Yu X, Wang X, et al., 2021, Intrinsic Capacity Predicts Adverse Outcomes Using the Integrated Care for Older People Screening Tool in a Senior Community in Beijing. Archives of Gerontology and Geriatrics, 94: 104358.