Physical Activity and Quality of Life in Hemodialysis Patients and Healthy Controls: A Cross-Sectional Study

Abstract

Hemodialysis (HD) patients have lower functional abilities compared to healthy people, and this is associated with lower physical activity in everyday life. This may affect their quality of life, but research on this topic is limited. Therefore, the present study aimed to determine the relationship between habitual physical activity and quality of life in HD patients and healthy controls. Ninety-three HD patients and 140 controls participated in the study. Quality of life was assessed using a 36-item medical outcomes study short-form health survey (SF-36). Human Activity Profile (HAP) was used to assess habitual physical activity. The adjusted activity score (AAS) from HAP, age, gender, fat tissue index (FTI), lean tissue index (LTI), and Davies comorbidity score were analyzed as possible predictors of the Physical Component Summary (PCS) of the SF-36. Three sequential linear models were used to model PCS. In Model 1, PCS was regressed by gender and age; in Model 2 the LTI, FTI, and Davies comorbidity scores were added. Model 3 also included AAS. After controlling for age and gender (ModelHD 1: p = 0.056), LTI, FTI, and Davies comorbidity score effects (ModelHD 2: p = 0.181), the AAS accounted for 32% of the variation in PCS of HD patients (ModelHD 3: p < 0.001). Consequently, the PCS of HD patients would increase by 0.431 points if the AAS increased by one point. However, in healthy controls, AAS had a lower impact than in the HD sample (B = 0.359 vs. 0.431), while the corresponding effects of age and gender (ModelH 1: p < 0.001), LTI, FTI, and Davies comorbidity score (ModelH 2: p < 0.001) were adjusted for. The proportion of variation in PCS attributed to AAS was 14.9% (ModelH 3: p < 0.001). The current study results showed that physical activity in everyday life as measured by the HAP questionnaire is associated to a higher degree with the quality of life of HD patients than in healthy subjects. Routine physical activity programs are therefore highly justified, and the nephrology community should play a leading role in this effort.

Physical Activity and Health-Related Quality of Life of Patients on Hemodialysis with Comorbidities: A Cross-Sectional Study

“…This confirmed that in patients on hemodialysis, regular exercise is a feasible and effective activity that can improve HRQoL and muscle strength and help delay their disease progression [ 25 , 26 ]. For these patients, the implementation of moderate-intensity exercise training programs (e.g., aerobic exercises) can effectively improve the physical role, general health, and pain management domains of their HRQoL; increase their social interactions and enhance their self-attitude [ 27 ]; alleviate their disease-related conditions and complications; and improve their physical functioning and prognosis [ 28 , 29 ]. A study indicated that the level of physical activity of patients on hemodialysis is correlated to their HRQoL; the study also reported that relative to healthy people, habitual exercise is a stronger predictor of HRQoL for patients on hemodialysis [ 30 ].…”

“…Studies have indicated that patients who have a lower educational level or no education, patients who are not married or widowed, patients who are unemployed, patients who have a low monthly income, and patients who have multiple comorbidities usually have poorer mental health, which directly affects their HRQoL and is negatively correlated with their quality of life. In addition, the quality of life of patients is negatively affected by a hemodialysis history of <2 years, lack of regular exercise, and lack of moderate-intensity exercise [ 29 , 43 , 44 ]. Therefore, regular physical activity is positively correlated with improvements in quality of life, PCS, and MCS.…”

Effect of Exercise on Health-Related Quality of Life in Patients with End-Stage Renal Disease

“…PE also benefits dialysis patients' physical health by improving CV function, blood pressure, muscle strength, and nutritional status, as well as improving dialysis quality [28]. For HD patients, PA in everyday life has a greater impact on QoL than it does in the general population [29].…”

Impacto de un programa de ejercicio físico domiciliario de intensidad leve-moderada sobre calidad de vida, fuerza, resistencia aeróbica, equilibrio y flexibilidad en pacientes adultos mexicanos trasplantados de riñón

“…Se evaluó mediante el formulario corto de 36 ítems (SF36) [38][39][40][41] que evalúa ocho dominios: funcionamiento físico, rol físico, dolor corporal, salud general, vitalidad, funcionamiento social, rol emocional y salud mental, cada pregunta se puntuó según una escala que va del 0 (peor estado de salud) a 100 (mejor estado de salud).…”