The 150 chronic hemodialysis patients who participated in our study are distributed as follows: Military Hospital of Guelmim: 27 patients (18%); Guelmim Regional Hospital: 60 patients (40%); Guelmim private hemodialysis center: 32 patients (21%); Sidi Ifni hemodialysis center: 20 patients (13%); Assa hemodialysis center: 05 patients (3%); Tan-Tan hemodialysis center: 06 patients (4%).
The average age of all of our patients was 54.6 +/- 16.4 years, with extremes ranging from 18 to 85 years, a male predominance was noted with a sex ratio of 89H / 61F. The demographics of our study population are summarized in Table 1.
Most patients have a low level of education and 38% of patients have no job. 65% of patients live at urban location, 30% are retired and 18% are students. The ministry of health payed hemodialysis for up 61% of patients and other were covered by a social security system (employees, military…)
12% of patients have an arteriopathy and 7% have a lower limb fracture. For comorbidities, we found hypertension in 54%, diabetes in 39% and cardiopathy in 10%
In order to assess the physical activity of our HD patients, we opted for the Baecke questionnaire that we adapted to our Moroccan socio-cultural context. This questionnaire was therefore administered orally by medical staff to consenting patients during HD sessions. Of all our HD patients, 19% of patients report having no physical activity. These are mainly patients assisted in their daily activities by a third person. 63% of cases report difficulty performing significant physical efforts (running, lifting a heavy object). Only 19% of patients report having regular physical and / or sporting activity (walking, football). Regarding the means of transport used to get to hemodialysis centers, most of our patients (88%) used a vehicle (car, motorbike, etc.) while only 11% came on foot.
The calculation of physical activity indices as part of the Baecke questionnaire revealed the following information: in patients who practice sports, the mean sports activity index (SAI) is: 0.79 +/- 0.7. Moreover, the average leisure activity index (LAI) is 2.45 +/- 1.2. The average of these 2 indices is equal to 1.62 +/- 0.8 which corresponds to a limited physical activity, and this in the different aspects of the daily life of our HD patients.
The calculation of physical activity indices as part of the Baecke questionnaire revealed the following information: in patients who practice sports, the mean sports activity index (SAI) is: 0.79 +/- 0.7. Moreover, the average leisure activity index (LAI) is 2.45 +/- 1.2. The average of these 2 indices is equal to 1.62 +/- 0.8 which corresponds to a limited physical activity, and this in the different aspects of the daily life of our HD patients.
- Low Physical activity risk factors:
To search risk factors of low activity, we compare two groups: group A with low physical activity defined by a global activity index (GAI) less than 5 and group B with intermediate or high physical activity (table 2). In univariate analysis we found that low activity is associated to age, female, living in rural area, diabetes, 2 dialysis sessions by week, use of anti-hypertension drugs and car for coming at hemodialysis center. However, after including all factors in a multivariate model only three risk factors still significant: elderly patients (OR = 1,03), female (OR = 4,05)and low education level (illiterate and primary school).