Patients on hemodialysis have lower level of physical activity due cardiovascular and musculoskeletal changes caused by chronic kidney disease and the hemodialysis process. The lower level of physical activity can contribute to the impairment of physical function, however, the relationship between postural balance and level of physical activity needs further investigation.

To evaluate the association between postural balance and level of physical activity in patients on hemodialysis.

A cross-sectional study was carried out with patients who were 18 years of age or older and who were on regular hemodialysis for at least three months. Patients unable to perform the proposed assessments, with psychiatric impairments and severe and/or unstable comorbidity were excluded. Postural balance was assessed by the Mini Balance Evaluation Systems Test (Mini-BESTest) and the level of physical activity was investigated by the daily steps count recorded by the accelerometer Actigraph wGT3X-BT. Data normality was verified using the Shapiro-Wilk test. The correlation between the Mini-BESTest score and the daily steps was calculated using the Spearman correlation coefficient (ρ) and the association between these variables was investigated using a multivariate linear regression model. The significance level was p < 0.05.

Ninety-six patients (59.2 ± 12.3 years; 57.3% male) were evaluated. The median of the Mini-BESTest score was 22.0 (4.0) and the median of daily step count was 3750 (3009). The Mini-BESTest score was positively correlated with the daily step count (ρ = 0.449; p < 0.001). This association remained statistically significant after adjusting for age, gender, time on hemodialysis, hemodialysis efficacy index, and presence of neurological disease (R = 0.540; R² = 0.292; adjusted R² = 0.243; p < 0.001).

This study showed that a better performance in postural balance was associated with a higher level of physical activity in hemodialysis patients.

Increasing the level of physical activity can be suggested in rehabilitation programs for hemodialysis patients and can contribute to improving the postural balance of these patients.