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Abstract: PO1755

Physical Activity in Patients Undergoing Dialysis: A Pilot Study

Session Information

Category: Health Maintenance, Nutrition, and Metabolism

  • 1300 Health Maintenance, Nutrition, and Metabolism

Authors

  • Guo, Denghui, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Fadel, William F., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Cranor, Alissa Ann, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Moe, Sharon M., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Avin, Keith G., Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Moorthi, Ranjani N., Indiana University School of Medicine, Indianapolis, Indiana, United States
Background

Patients on chronic dialysis have impaired physical function and poor quality of life. Slow gait speed and handgrip strength are indicators of increased all-cause mortality and cardiovascular events in dialysis patients. The relationship between physical activity and gait speed is inconsistent in prior studies. ”Cadence”, a gait characteristic measured as steps/minute by accelerometer is strongly associated with the intensity of physical activity. We hypothesized that cadence will be lower in dialysis patients compared to healthy adults and that cadence will be correlated with their gait speed.

Methods

Physical activity was measured in N=20 subjects incident to dialysis over 7 days using a validated wrist worn tri-axial accelerometer (ActiGraph). The 7 days included dialysis and non-dialysis days. Average daily cadence (steps/sec) was extrapolated from accelerometer data utilizing a published algorithm. Subject demographics were recorded by self-report or from medical records. Gait speed (meter/sec) was measured over 4 meters. Data on cadence from healthy subjects (N=32) were obtained from a prior study.

Results

Of twenty subjects (4 peritoneal dialysis, 16 hemodialysis), no one recorded any vigorous activity in the entire period, while most (59.4%) of their time was spent in sedentary behavior. Median average daily cadence across subjects was 1.38 [IQR = (1.31 – 1.48)] steps/second. Dialysis subjects had lower average daily cadence than healthy subjects (1.38 vs 1.66 steps/second, p <0.001). When adjusted for age and sex, being “on dialysis” was associated with a 0.24 (95% CI -0.34, -0.14) steps/second lower cadence compared to healthy subjects. For patients on hemodialysis, average daily cadence was not significantly different between HD days and non-HD days, with no significant correlation between 4m speed and cadence (r=-0.28).

Conclusion

In this prospective study, we show that cadence is low in dialysis patients, that dialysis patients are sedentary and cadence does not correlate with gait speed. Thus gait speed alone may not be an accurate representation of intensity of daily physical activity. This pilot study supports the need for detailed studies of gait characteristics in dialysis patients, which will help in the development of personalized exercise and activity programs in patients undergoing dialysis.