Use of Pedometers to Measure and Increase Walking Among Patients With ESRD (PED)

Experimental: pedometer

Patients will be given pedometers and instructions to increase physical activity based on pedometer output

Conductual: pedometer

pedometer-based physical activity recommendations

Sin intervención: usual care

No intervention

Physical Activity

change in steps per day from pedometer

Physical Performance

change in score on the Short Physical Performance Battery (0-12), higher scores indicate greater physical performance

Self-reported Physical Functioning

Change in score on the Physical Function scale of the Short-Form 36 Health Survey (scale from 0-100, higher numbers indicate better physical functioning)

Change in Activities of Daily Living Score

Barthel's Index of Daily Activities (Index range 0-20, higher scores indicate greater functional independence)

Change in Symptom Burden on the Dialysis Symptoms Index

Dialysis symptom index (symptom burden ranges from 0 - 29 symptoms experienced)

Change in Total Body Muscle Mass (Adjusted by Height Squared)

(TBMM calculated from measurements of intracellular water from bioimpedance spectrometry)

Change in Endothelial Function

Reactive hyperemia index (RHI) using peripheral arterial tonometry. RHI is a non-invasive measure of endothelial function, measured using the EndoPAT 2000 (Itamar Medical). The pulse amplitude in the middle fingers of both hands was recorded for five minutes. A blood pressure cuff was then inflated in one arm (which did not have a vascular access in place) to at least 60 mmHg above systolic blood pressure to achieve full occlusion (minimum 200 mmHg, maximum 300 mmHg). After occlusion for 5 minutes, the cuff was deflated, and the device recorded changes in pulse amplitude for an additional 5 minutes and calculated RHI as the ratio of the post to pre occlusion amplitude of the occluded arm relative to the post to pre occlusion amplitude of the control arm, corrected for baseline vascular tone.

Change in the Short From 36 Vitality Scale

Short Form 36 Vitality Scale (0-100, greater values indicate increased levels of energy/decreased levels of fatigue)

Change in SDNN (ms)

Standard deviation of N-N intervals as recorded on electrocardiography waveform (ms)

Change in Symptom Severity on Dialysis Symptoms Index

Symptoms range from score of 0 (Not at all bothersome) to 5 (Very Bothersome) over 29 symptoms. Score ranges from 0 - 145