This study aimed to evaluate the reliability and validity of the Japanese adaptation of the HAP questionnaire among patients undergoing hemodialysis.
We included 20 Japanese patients undergoing hemodialysis (mean age 72.4±9.1 years; 15 men; median dialysis duration 4.3 [0.5, 17.4] years). Demographic data and information on primary kidney disease were collected from medical records at study entry. The Japanese adaptation of the HAP was professionally translated and verified through multiple bidirectional translations to ensure accuracy. Physical activity was assessed using both the HAP questionnaire and a wrist-worn accelerometer. Participants were instructed to wear the accelerometer continuously, except during bathing and sleeping, for 7 consecutive days. Total steps and moderate-to-vigorous physical activity (MVPA) time were calculated for analysis. Validity was assessed by evaluating the correlation between HAP’s maximum activity score (MAS) and adjusted activity score (AAS) and objectively measured physical activity levels. Reliability was determined by re-administered the HAP questionnaire four weeks after the initial test. The concurrent validity of the HAP and the International Physical Activity Questionnaire (IPAQ) long form was analyzed using accelerometer data. Spearman's rank correlation coefficient and intraclass correlation coefficients (ICC) 2,1 were used to evaluate validity and reliability, respectively.
Correlation coefficients of 0.57 were found between MAS and accelerometer data for MVPA over a week and on non-dialysis days. Correlation coefficients of 0.5, 0.49, 0.67, and 0.59 were found between AAS and accelerometer data for total steps over a week and on non-dialysis days, as well as for MVPA over a week and on non-dialysis days, respectively. Correlation coefficients of 0.6, 0.52, and 0.55 were found between the IPAQ long form and accelerometer data for MVPA over a week and on non-dialysis days, respectively. Correlation coefficients of 0.53 and 0.67 were found between the IPAQ long form and MAS and AAS, respectively. Test-retest reliability yielded ICC values of 0.86 for MAS and 0.87 for AAS.
We demonstrated the robust reliability and validity of the Japanese version of the HAP questionnaire in patients undergoing hemodialysis.
Given the strong reliability and validity of the Japanese HAP questionnaire, incorporating this assessment into standard care could be a valuable enhancement for evaluating physical activity in patients undergoing hemodialysis.
frailty
sedentary
