Use of Pedometers to Increase Physical Activity among Children and Adolescents with Chronic Kidney Disease.

Table 1. The study included:
Author, Year, Title, and Source Design and General Quality Sample Size and Participants
Interventions Outcomes
Akber, A., Portale, A. A., & Johansen, K. L. (2014). Use of Pedometers to Increase Physical Activity
among Children and Adolescents with Chronic Kidney Disease. Pediatr Nephrol, 1395-1402.
This experimental study sought to investigate if a pedometer-based intervention would increase
the number of steps walked per day by the children diagnosed with CKD (Chronic Kidney Disease).
Additionally, it sought to find out the relation between improvements in physical function or QOL with
an increase in physical activity. For this study, the participants were Children and adolescents
in the ages between seven and twenty years who were diagnosed with CKD and ESRD from the UCSF Pediatric
Nephrology Outpatient Clinic and Children’s Outpatient Hemodialysis Center (Akber, Portale, & Johansen,
2014).
The purpose of the pedometer-based intervention was to raise the average number of steps of a patient
to the recommended targets of 15000 and 12000 steps for boys and girls respectively. The research then
contacted the patients through telephone or e-mail requesting them to relay their step count logs
records (Akber, Portale, & Johansen, 2014).
The outcomes were measured at a baseline of two weeks to twelve weeks where the very inactive patients
recorded a median of 5976 steps daily. The girls were found to be substantially inactive compared to
boys with a median steps per day being 4,027 verses 9,122. Additionally, these outcomes indicated that
the activity for both boys and girls was significantly lower than the recommended targets.
The transplant recipients were more active(having a median of 8175 steps per day) compared to those
with CKD or ESRD(having a median of 4978 and 4566 steps per day respectively) (Akber, Portale, &
Johansen, 2014).
Table 2. The evidence rating and summary of findings:
Author, Year, Title, and Source Level of Evidence Findings’ summary
Akber, A., Portale, A. A., & Johansen, K. L. (2014). Use of Pedometers to Increase Physical Activity
among Children and Adolescents with Chronic kidney Disease. Pediatr Nephrol, 1395-1402.
III Making evaluations on interventions such as the pedometer-based intervention can
facilitate in comprehending the dynamics of conditions that CKD and ESRD patients face. Consequently,
improved services can be delivered to ensure an improvement in the quality of life of the patients. The
multivariate analysis carried out in the study showed that the intervention led to a change in the
activity of CKD that was an increase of 100 steps per day each week. Additionally, the 6-min walk
distance was significantly longer at the end of the 12 week intervention. A change in the physical
activity was linked to a change in the 6-min walk distance. Another significant finding was that
providing patients with pedometers as well as counselling them did not increase the physical activity
for the 12 weeks. It was notable that the parental input was a significant factor in the implementation
of the intervention. Consequently, parents should encourage their children to engage in physical
activities.

Table 1: The study include:
Author, Year, Title and Source Design and General Quality The Participants and Sample Size
Interventions Outcomes
Lopes, M., Ferraro, A., & Koch, V. H. (2014). Health-Related Quality of Life of Children and
Adolescents with CKD Stages 4-5 and their Caregivers. Pediatr Nephrol, 1239-1247.

This cross-sectional, descriptive, comparative and analytical study focused on describing the
perception of HRQoL (health-related quality of life) of the children/adolescents diagnose with CKD and
their primary caregivers (PC), and comparing it with that of the healthy peers and their PCs. The study
was based on the Peds QLTM 4.0 and Short Form-36(SF-36) questionnaires and chosen biomarkers (Lopes,
Ferraro, & Koch, 2014)
The participants in this study comprised of patients with CKD in stage 4-5 aged between one and
eighteen years and their PCs. These patients were receiving treatment care from Pediatric Nephrology
Unit of “Instituto da Crianca of the Hospital das Clinicas of University of Sao Paulo Medical School.
The participants in the control group comprised of healthy children/adolescents and their PC. The
objective was to increase the comprehension of HRQoL perception of the CKD (stages 4 and 5) patients
and their PC, and comparing it with their healthy peers and PC.
Consequently, this should pave the way to address the challenges affect these patients. The therapeutic
intervention may be hindered by the psychological and emotional conditions emanating from PC.
According to the study, patients undergoing dialysis reported lower HRQoL score compared to those who
received conservative treatment. However, the PC perception on HRQoL did not change across the
different treatment modalities (Lopes, Ferraro, & Koch, 2014).
Additionally, the patients diagnosed with CKD (stages 4-5) faced challenges in areas of social
interaction, physical activities, and education. In essence, the older participants in these domains
reported pronounced negative impacts (Lopes, Ferraro, & Koch, 2014).
Table 2. The evidence rating and summary of findings:
Authors, Year, Topic, and Source The level of Evidence The Summary of Findings
Lopes, M., Ferraro, A., & Koch, V. H. (2014). Health-Related Quality of Life of Children and
Adolescents with CKD Stages 4-5 and their Caregivers. Pediatr Nephrol, 1239-1247 II The
findings of this study indicate that the HRQoL score for the children/adolescents with CKD (stages 4-5)
was significantly lower than that of their healthy peers. Indeed, the study shows that there exists
discrepancies on the QoL reports between pediatric patients and their PC. Additionally, the therapeutic
intervention of CKD (stages 4-5) is very demanding due to the many changes that need to be made in the
pursuant of metabolic and acid-base balance (Lopes, Ferraro, & Koch, 2014).
Table 1: The study include:
Author, Year, Title and Source Design and General Quality The Participants and Sample Size
Interventions Outcomes

Brunelli, G., Nogueira, K. C., Pestana, J. M., & Diniz, D. H. (2012). Quality of Life in Children on
Dialysis. Int Urol Nephrol, 1515-1519. This cross-sectional study provided an analysis of the quality
of life of a pediatric population and compared it with that of the healthy. This controlled trial
utilized the Autoquestionnaire Qualite de Vie Enfant Image for data collection (Brunelli, Nogueira,
Pestana, & Diniz, 2012)
The participants of this study comprised of a sample of patients drawn randomly from the pediatric
population that attended outpatient units in two Brazilian states hospital. The control group consisted
of healthy children selected from three institutions found in two major cities in Brazilian states
(Brunelli, Nogueira, Pestana, & Diniz, 2012)
This study embarks on the objective of assessing the perception of QOL of children diagnosed with ESRD
with the aim of increasing the comprehension of the needs of the patients The assessment of QOL
showed that there were significant differences between the two groups. In essence, about 87.8% of the
healthy children were comfortable with engaging in sports. In contrast, only 51.5% of those diagnosed
with ESRD were satisfied with sporting. However, there were no significant variations between the
peritoneal dialysis and hemodialysis groups (Brunelli, Nogueira, Pestana, & Diniz, 2012). .
Table 2. The evidence rating and summary of findings:
Authors, Year, Topic, and Source The level of Evidence The Summary of Findings
Brunelli, G., Nogueira, K. C., Pestana, J. M., & Diniz, D. H. (2012). Quality of Life in Children on
Dialysis. Int Urol Nephrol, 1515-1519.
II According to this study, there were significant differences on the measure of practice
of sport between the healthy and ESRD diagnosed children. Additionally, the study found a trend towards
differences relating to perception of patients when with their family..

References:
1-Akber, A., Portale, A. A., & Johansen, K. L. (2014). Use of Pedometers to Increase Physical Activity
among Children and Adolescents with Chronic Kidney Disease. Pediatr Nephrol, 1395
1402.
2- Lopes, M., Ferraro, A., & Koch, V. H. (2014). Health-Related Quality of Life of Children and
Adolescents with CKD Stages 4-5 and their Caregivers. Pediatr Nephrol, 1239-1247.
3- Brunelli, G., Nogueira, K. C., Pestana, J. M., & Diniz, D. H. (2012). Quality of Life in Children on
Dialysis. Int Urol Nephrol, 1515-1519.

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