#6447 ASSOCIATION BETWEEN PHYSICAL ACTIVITY LEVEL AND A HISTORY OF FALLS IN PATIENTS ON HEMODIALYSIS

Abstract

Abstract Background and Aims Patients with end-stage renal disease on hemodialysis have a lower physical activity level in daily life and a higher prevalence of sedentary lifestyle. Moreover, these patients have clinical, musculoskeletal, and physical function complications that contribute to a higher risk of falling. Therefore, the aim of this study was to evaluate the association between physical activity level and a history of falls in a retrospective 12-month interval in patients on hemodialysis. Method A retrospective study was conducted with patients aged ≥18 years who were undergoing regular hemodialysis treatment for at least three months. Patients were excluded if presented severe and unstable comorbidities, psychiatric or cognitive disorders, uncorrected visual impairments, and hospitalization in the past three months. The retrospective history of falls was assessed for the last 12 months, and a fall was defined as an “unexpected event in which the individual comes to rest on the ground, floor or lower level”. 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). Normality of data was analyzed using the Shapiro-Wilk test. The Student's t-test and the Mann-Whitney U test were used for between-group comparisons (patients with and without a history of falls). The univariate and multivariate linear regression models investigated the association between daily step counts and a history of falls. A p value <0.05 was considered as statistically significant. Results This study included 103 patients (59.2 ± 12.6 years, 59.2% male). Of these patients, 49.5% had a history of falls. Patients with a history of falls showed lower prevalence of workers (9.8% vs. 26.9%, p = 0.025) and daily step counts [2989 (2595) vs. 4550 (2966) steps, p = 0.018], and higher educational level [9 (7) vs. 5 (5) years, p = 0.033] compared to patients without a history of falls. The univariate linear regression model showed that daily step counts was significantly associated with a history of falls (p = 0.017). After adjusting for age, gender, educational level, work status, hemoglobin, and diabetes mellitus, this association remained significant in multiple linear regression model with a coefficient of determination of 0.21 and an adjusted coefficient of determination of 0.16 (p = 0.001). Conclusion Physical activity level was associated with a history of falls in a retrospective 12-month interval in patients on hemodialysis.