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. 2020 Aug 31;14(3):950-958.
doi: 10.1093/ckj/sfaa045. eCollection 2021 Mar.

Accelerometer-measured physical activity and functional behaviours among people on dialysis

Khizr A Nawab  1   2 , Benjamin C Storey  1 , Natalie Staplin  2   3   4 , Rosemary Walmsley  2 , Richard Haynes  1   3   4 , Sheera Sutherland  1 , Sarah Crosbie  1 , Christopher W Pugh  1   5 , Charlie H S Harper  2   3 , Martin J Landray  2   3   4   6 , Aiden Doherty  2   6 , William G Herrington  1   3   4
Affiliations

Accelerometer-measured physical activity and functional behaviours among people on dialysis

Khizr A Nawab et al. Clin Kidney J. .

Abstract

Background: The feasibility of wrist-worn accelerometers, and the patterns and determinants of physical activity, among people on dialysis are uncertain.

Methods: People on maintenance dialysis were fitted with a wrist-worn AxivityAX3 accelerometer. Subsets also wore a 14-day electrocardiograph patch (Zio®PatchXT) and wearable cameras. Age-, sex- and season-matched UK Biobank control groups were derived for comparison.

Results: Median (interquartile range) accelerometer wear time for the 101 recruits was 12.5 (10.4-13.5) days, of which 73 participants (mean age 66.5 years) had excellent wear on both dialysis and non-dialysis days. Mean (standard error) overall physical activity levels were 15.5 (0.7) milligravity units (mg), 14.8 (0.7) mg on dialysis days versus 16.2 (0.8) mg on non-dialysis days. This compared with 28.1 (0.5) mg for apparently healthy controls, 23.4 (0.4) mg for controls with prior cardiovascular disease (CVD) and/or diabetes mellitus and 22.9 (0.6) mg for heart failure controls. Each day, we estimated that those on dialysis spent an average of about 1 hour (h/day) walking, 0.6 h/day engaging in moderate-intensity activity, 0.7 h/day on light tasks, 13.2 h/day sedentary and 8.6 h/day asleep. Older age and self-reported leg weakness were associated with decreased levels of physical activity, but the presence of prior CVD, arrhythmias and listing for transplantation were not.

Conclusions: Wrist-worn accelerometers are an acceptable and reliable method to measure physical activity in people on dialysis and may also be used to estimate functional behaviours. Among people on dialysis, who are broadly half as active as general population controls, age and leg weakness appear to be more important determinants of low activity levels than CVD.

Keywords: age; cardiovascular; epidemiology; haemodialysis; physical activity.

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Figures

FIGURE 1
FIGURE 1
Accelerometer-measured vector magnitude (A), and estimates of time spent walking (B), in sedentary activity (C) and asleep (D) for the Oxford cohort and UK Biobank controls.
FIGURE 2
FIGURE 2
Accelerometer-measured average vector magnitude for the Oxford dialysis cohort on dialysis days (A) and non-dialysis days (B), by dialysis time slot.
FIGURE 3
FIGURE 3
Accelerometer-measured average vector magnitude (A), probability of walking (B), sedentary activity (C) and sleep (D) for the Oxford dialysis cohort and UK Biobank controls, by time of day.
See this image and copyright information in PMC

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