Abstract
BackgroundValid instruments for measuring physical activity at the low end of the physical activity range and producing quantitative results are required among dialysis patients who are extremely inactive. This study aimed to translate and adapt a Chinese version of the low physical activity questionnaire (LoPAQ) and to examine its reliability and validity among hemodialysis patients.MethodsThis was a cross-sectional study. The LoPAQ was translated into Chinese and culturally adapted following the standardized questionnaire adaptation process. Participants wore an ActiGraph for seven consecutive days and were asked to complete the Chinese version of the LoPAQ (C-LoPAQ) following the ActiGraph monitoring period. The criterion validity of the C-LoPAQ was examined with accelerometers using Spearman’s correlation coefficients. Bland-Altman plots were adopted to determine the absolute agreement between methods. The test-retest reliability was analyzed using the intraclass correlation coefficient (ICC).ResultsEighty-five hemodialysis patients had valid accelerometers and C-LoPAQ data. The total walking time reported on LoPAQ was correlated with step counts by ActiGraph (rho = 0.47, p < 0.01). A moderate correlation was also observed between the C-LoPAQ and the ActiGraph-measured physical activity for total calories (rho = 0.44, p < 0.01). There was a fair correlation between ActiGraph-measured sedentary time and C-LoPAQ-measured inactive time (rho = 0.22, p < 0.05). The test-retest reliability coefficients of C-LoPAQ ranged from 0.30 to 0.66.ConclusionsThe C-LoPAQ demonstrated moderate validity for measuring low levels of physical activity, especially walking, and total kilocalories of physical activity among hemodialysis patients in China.
Highlights
Valid instruments for measuring physical activity at the low end of the physical activity range and producing quantitative results are required among dialysis patients who are extremely inactive
There was a fair correlation between ActiGraph-measured sedentary time and C
A total of 85 maintenance hemodialysis (MHD) patients who had valid ActiGraph and C-low physical activity questionnaire (LoPAQ) data were included in the data analysis, among whom 56 (65.9%) were from Renji Hospital (58.9 and 41.1% for each hemodialysis unit) and 29 (34.1%) were from Tongren Hospital
Summary
Valid instruments for measuring physical activity at the low end of the physical activity range and producing quantitative results are required among dialysis patients who are extremely inactive. Numerous CKD patients will progress to end-stage renal disease (ESRD), which necessitates renal replacement therapy including maintenance hemodialysis (MHD) and peritoneal dialysis (PD) [3]. Several studies have confirmed the relationship between a low physical activity level and the increased risk of cardiovascular disease in MHD patients [5, 6], which was the leading cause of morbidity and mortality in these patients [7, 8]. Beddhu et al [9] reported a 40% higher mortality rate in CKD patients with low physical activity levels than in those with higher levels. Appropriate moderate physical activity helps prevent muscle loss, control comorbidities, improve quality of life, and reduce the mortality rate in MHD patients [10, 11]
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