Abstract: FR-PO792

Exploring Walking Pace, Physical Activity, and Readiness to Change in ESRD

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Song, Yan, University of Leicester, Leicester, Leicestershire, United Kingdom
  • Highton, Patrick J., Loughborough University, Leicester, United Kingdom
  • Clarke, Amy L., University of Leicester, Leicester, Leicestershire, United Kingdom
  • Burton, James, University of Leicester, Leicester, Leicestershire, United Kingdom
  • Smith, Alice C., John Walls Renal Unit, Leicester General Hospital, Leicester, United Kingdom
Background

Reduced physical function and walking speed in end stage renal disease (ESRD) patients are associated with increased morbidity and mortality and high healthcare costs. Physical activity (PA) and regular exercise may optimize physical function, but the majority of ESRD patients are sedentary. This study explored walking speed, PA and exercise, and readiness to change exercise behavior in patients on haemodialysis (HD).

Methods

1156 patients (M: F 1.8:1, median (IQR) age 63.01(21.00) years) from 16 disparate HD networks completed a series of validated questionnaires: GP Physical Activity Questionnaire (GPPAQ providing Physical Activity Index [PAI] and Walking Speed [WS]), Leisure Time Exercise Questionnaire (LTEQ, providing an exercise Health Contribution Score (HCS) based on METS) and Stage of Change Questionnaire (SoCQ, defining readiness to change exercise behaviour).

Results

The distribution of PAI, WS, HCS and SoC are shown in Table 1. Walking pace was negatively associated with older age, female sex (P<0.01) and longer dialysis vintage (P<0.05), and positively associated with behavioural factors (physical activity, leisure time exercise), and readiness to change (all P<0.01).

Conclusion

GPPAQ and LTEQ responses highlight the inactive lifestyle of HD patients. The majority have slow walking speed which is a strong predictor of poor outcome and indicates the need for functional improvement. Exercise interventions have been shown to improve walking speed in older frail adults and may be beneficial for ESRD patients. However, walking speed was positively associated with stage of change indicating that the most vulnerable patients (slow walking pace, older age, female, low PA) may require targeted support to engage in exercise programmes to improve outcomes.

Table 1 Distribution of Physical Activity Index, Walking Speed, Exercise Health Contribution Score and Stage of Change in HD patients
QuestionnaireHD patients in each category n (%)
GPPAQPAIInactiveModerately InactiveModerately ActiveActive
907 (78.5)78(6.7)59(5.1)49(4.2)
Walking speedSlowSteadyBriskFast
736 (63.7)266 (23.0)39(3.4)18(1.6)
LTEQHCS<14
(Insufficient for benefit)
14-23
(Some benefit)
≥24
(Substantial benefit)
947 (81.9)42(3.6)73(6.3)
SoCQPre-ContemplationContemplationPreparationActionMaintenance
460 (44)215(20)202(19)48(5)129(12)

Funding

  • Private Foundation Support