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Rehabilitation Practice and Science

Abstract

Background: Sedentary lifestyles and poor fitness are prevalent among patients undergoing maintenance hemodialysis (HD). However, no study has comprehensively evaluated multiple dimensions of physical fitness using gold-standard methods in ambulatory chronic HD patients, who represent approximately 60% of the HD population. In this study, a multidimensional health assessment -including standardized evaluations of fitness—was conducted to examine its association with physical activity levels.

Methods: This cross-sectional study assessed patients receiving maintenance hemodialysis at dialysis centers within a tertiary medical center and a regional hospital, using a comprehensive battery of evaluations. These included cardiopulmonary exercise testing, isokinetic dynamometry, dual-energy X-ray absorptiometry (DXA), handgrip strength (HGS), the Kidney Disease Quality of Life (KDQOL) questionnaire, the Mini Nutritional Assessment (MNA), hemogram analysis, and the International Physical Activity Questionnaire (IPAQ). Statistical analyses included two-sample t tests, linear regression, Pearson correlation, and partial correlation.

Results: Of the 62 participants, 29% had a peak V̇O2 of /min/kg with mean predicted peak V̇O2 of 63%. 24% had sarcopenia, and 40% were sedentary, of whom 40% developed sarcopenia. Inactivity was associated with low cardiorespiratory fitness, quadriceps strength, HGS, muscle mass, KDQOL, MNA scores, and higher neutrophil-to-lymphocyte ratio and reticulocyte distribution width coefficient of variation, emerging as a major determinant of physical component score in QOL.

Conclusions: The prevalence of sedentariness, sarcopenia, and low peak V̇O₂ is high among ambulatory patients undergoing chronic hemodialysis (HD). Physical inactivity was linked to higher prevalence of sarcopenia and various adverse health outcomes.

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