#5759 Association Between Physical Activity Level Questionnaires and Daily Step Counts in Patients on Hemodialysis

Abstract

Background and Aims In patients on hemodialysis, sedentary lifestyle is highly prevalent and associated with elevated mortality. The sedentary lifestyle of these patients can be confirmed by assessing the physical activity level (PAL) evaluated by accelerometers and questionnaires. Considering that the PAL questionnaires are quick to perform and inexpensive, the aim of this study was to evaluate the association of three PAL questionnaires with daily step counts measured by an accelerometer in patients on hemodialysis. Method A cross-sectional study was conducted with patients aged ≥18 years who were undergoing hemodialysis treatment for at least three months. Patients were excluded if presented severe and unstable comorbidities, psychiatric or cognitive disorders, and hospitalization in the past three months. The daily step counts were recorded in the ActiGraph accelerometer (wGT3X-BT) during seven days, and analyzed by excluding the first and last day of recording and calculating the mean among the valid days (≥ 8 hours of wear time). Subsequently, the Human Activity Profile (HAP) questionnaire, the International Physical Activity Questionnaire (IPAQ) and the physical functioning domain of the 36-Item Short Form Survey (PF SF-36) were applied. The normality of the data was analyzed using the Shapiro‒Wilk test. The associations between each PAL questionnaire score and daily step counts were tested using Spearman´s correlation coefficients. Then, three multiple linear regression models were constructed with daily step counts as the dependent variable and PAL questionnaire score and potential confounders (age, gender, educational level, time on dialysis, hemoglobin, and body mass index) as independent variables. A p value <0.05 was considered as statistically significant. Results This study included 105 patients (59.2 ± 12.5 years, 60.0% male). Daily step counts correlated significantly with the questionnaires scores (HAP, ρ = 0.552, p < 0.001; IPAQ, ρ = 0.386, p < 0.001; PF SF-36, ρ = 0.337, p < 0.001). After adjusting for potential confounders, the multiple linear regression models showed an association between daily step counts with the HAP questionnaire score (R2 = 0.31; adjusted R2 = 0.26; p < 0.001) and PF SF-36 score (R2 = 0.23; adjusted R2 = 0.18; p = 0.001). Conclusion The PAL questionnaires were associated with daily step counts measured by an accelerometer in patients on hemodialysis. However, our results suggest that the HAP was the best questionnaire to evaluate PAL in these patients.