Associação de dados do acelerômetro com questionários de nível de atividade física em pacientes em hemodiálise

Abstract

Introduction: The assessment of physical activity levels can be conducted using different instruments, and despite existing evidence demonstrating that the Human Activity Profile (HAP), International Physical Activity Questionnaire (IPAQ), and 36-Item Short Form Survey (SF-36) questionnaires are associated with accelerometer data in hemodialysis patients, the investigation of which of them exhibits the strongest association, as well as the ability of the scores to discriminate physically inactive from active patients, needs to be confirmed. Therefore, utilizing questionnaires as a quick and cost-effective strategy may render the assessment of physical activity levels more feasible in clinical practice. Objectives: To assess the association between accelerometer data and scores from physical activity level questionnaires (HAP-EAA, IPAQ, and SF-36) in hemodialysis patients and investigate the ability of each questionnaire score to discriminate physically inactive from active patients. Methods: A cross-sectional study with adult patients undergoing hemodialysis for at least three months. Physical activity levels were assessed through accelerometer data and the HAP, IPAQ, and SF-36 questionnaires. Associations between accelerometer data and questionnaire scores were tested using Pearson or Spearman correlation coefficients, depending on the normality of the data. A multiple linear regression model was constructed for each questionnaire, considering potential confounding factors. The ability of questionnaire scores to discriminate physically inactive from active patients based on step count was analyzed using ROC curves. A p-value < 0.05 was considered statistically significant. Results: A total of 105 patients were included, with a mean age of 59.2 ± 12.5 years, and 60% were male. Accelerometer data showed a significant correlation with questionnaire scores. However, only the adjusted HAP questionnaire score exhibited a moderate to strong correlation with step count and time spent in moderate and vigorous physical activity. This association remained significant after adjusting for potential confounding factors (age, sex, education level, body mass index, diabetes mellitus, Kt/V, and hemoglobin) in the linear regression models. The cutoff points for questionnaire scores to discriminate between sedentary and physically active patients were as follows: HAP = 63, IPAQ = 1139 METs/min/week, and SF-36 (functional capacity domain) = 44.