title: Barriers to physical activity in chronic hemodialysis patients: a single-center pilot study in an Italian dialysis facility.
abstract: OBJECTIVE
  In patients on chronic dialysis a sedentary lifestyle is a strong, yet potentially modifiable, predictor of mortality. The present single-center pilot study evaluated social, psychological and clinical barriers that may hinder physical activity in this population.
  
  
  METHODS
  We explored the association between barriers to physical activity and sedentarism in adult patients at a chronic dialysis facility in Parma, Italy. We used different questionnaries exploring participation in physical activity, physical functioning, patient attitudes and preferences, and barriers to physical activity perceived by either patients or dialysis doctors and nurses.
  
  
  RESULTS
  We enrolled 104 patients, (67 males, 65%), mean age 69 years (79% of patients older than 60 years); median dialysis vintage 60 months (range 8-440); mean Charlson score 5.55, ADL (Activities of Daily Living) score 5.5. Ninety-two participants (88.5%) reported at least one barrier to physical activity. At multivariable analysis, after adjusting for age and sex, feeling to have too many medical problems (OR 2.99, 95% CI 1.27 to 7.07; P=0.012), chest pain (OR 10.78, 95% CI 1.28 to 90.28; P=0.029) and sadness (OR 2.59, 95% CI 1.10 to 6.09; P=0.030) were independently associated with physical inactivity. Lack of time for exercise counseling and the firm belief about low compliance/interest by the patients toward exercise were the most frequent barriers reported by doctors and nurses.
  
  
  CONCLUSIONS
  We identified a number of patient-related and health personnel-related barriers to physical activity in patients on chronic dialysis. Solutions for these barriers should be addressed in future studies aimed at increasing the level of physical activity in this population.
authors.affiliation: Renal Pathophysiology Unit, Clinical and Experimental Medicine Department, University of Parma, Parma, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Fiaccadori
authors.forename: Alice
authors.initials: A
authors.lastname: Sabatino
authors.forename: Franco
authors.initials: F
authors.lastname: Schito
authors.forename: Francesca
authors.initials: F
authors.lastname: Angella
authors.forename: Martina
authors.initials: M
authors.lastname: Malagoli
authors.forename: Marco
authors.initials: M
authors.lastname: Tucci
authors.forename: Adamasco
authors.initials: A
authors.lastname: Cupisti
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capitanini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Regolisti
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D009043:Motor Activity; D009726:Nurses; D010361:Patients; D010820:Physicians; D010865:Pilot Projects; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000503:physiopathology* / Q000628:therapy*