Utility of the low physical activity questionnaire for hemodialysis patients with frailty: a cross-sectional study

Abstract

Abstract Background The low physical activity questionnaire (LoPAQ), which has been developed to assess the low levels of physical activity in patients on dialysis, is so far available only in English. Moreover, no study has examined whether the LoPAQ can be used to screen for frailty in patients on hemodialysis. The purpose of this study was to translate the original LoPAQ into Japanese and evaluate its utility in screening for frailty among patients on hemodialysis. Methods For this cross-sectional study, we enrolled patients from two hemodialysis facilities in Japan between April 2018 and June 2019. We used the LoPAQ to calculate physical activity for one week, with pedometer steps (steps/week) as the standard reference. We used Spearman’s rank test and two multiple linear regression models to assess the relationship between the Japanese LoPAQ results and pedometer step counts. Finally, we examined whether the LoPAQ had the ability to screen for frailty (Fried scale ≥ 3) using area under the curves. Results In total, 220 patients on hemodialysis completed the LoPAQ and wore a pedometer for one week. Their mean age was 67.8 ± 11.6 years, and 59.1% were men. The LoPAQ showed a total physical activity of 825.0 kilocalories/week and walking activity of 315.0 kilocalories/week. The LoPAQ total physical activity and walking activity were significantly correlated with pedometer step counts (r = 0.37–0.53, P < 0.01). Furthermore, LoPAQ total physical activity and walking activity were associated with pedometer step counts despite adjusting for covariates (β: 3.33–5.45, P < 0.001, β: 8.63–16.80, P < 0.001, respectively). In addition, the LoPAQ total physical activity and walking activity showed good values in the area under the curves to identify frailty (0.72 and 0.73, respectively). Conclusions Physical activity assessed using the LoPAQ significantly correlated with pedometer step counts in Japanese patients on hemodialysis. Furthermore, the LoPAQ total physical activity and walking activity had a moderate screening ability for frailty. The results indicate that the LoPAQ questionnaire is useful as a physical activity assessment tool and as a screening tool for frailty in patients on hemodialysis.