# Properties of Measurements of Patient‐Reported Outcome Measures Physical Activity Assessment in Chronic Kidney Disease: A Systematic Review

## TL;DR

This systematic review evaluates physical activity questionnaires for chronic kidney disease patients, finding limited consensus and highlighting the CKD-PAQ as a promising tool.

## Contribution

Identifies psychometric properties of PROMs for physical activity in CKD and highlights the CKD-PAQ as the only tool with favorable evaluations.

## Key findings

- Only the CKD-PAQ showed satisfactory results in both COSMIN RoB and EMPRO evaluations.
- There is no consensus on the best PROM for assessing physical activity in CKD.
- Few studies focus on early-stage CKD or evaluate responsiveness of PROMs.

## Abstract

The assessment of physical activity (PA) using Patient‐Reported Outcome Measures (PROMs) is routine due to its easy applicability and low cost. In the context of CKD, there are several studies that evaluate PA through PROM, but there is heterogeneity in the choice of tool. Therefore, the objective of this study was to identify, evaluate and synthesize the psychometric properties of PROMs used in the assessment of PA in CKD.

A systematic review was carried out according to the PRISMA guidelines in PubMed, SciELO, Medline, Lilacs and EMBASE databases. The assessment of the quality of the studies was evaluated using the COSMIN Checklist and EMPRO tool.

15,137 studies were found, with 17 included. Eleven PROMs were found, of which 2 were elaborate to the CKD population: Chronic Kidney Disease Physical Activity Questionnaire (CKD‐PAQ) and Low Physical Activity Questionnaire (LoPAQ). Criterion validity was the most evaluated psychometric property. Only CKD‐PAQ shows satisfactory results in both evaluation tools for the psychometric properties evaluated.

This systematic review found no consensus in the literature for the best PROM for assessing PA in CKD. However, the CKD‐PAQ appears to be promising as the only PROM with a favorable evaluation by both COSMIN RoB and EMPRO. There is a lack of studies evaluating PA in the early stages of CKD and its responsiveness, indicating a gap in the research. COSMIN RoB and EMPRO differed from each other, showing that the choice of the evaluation tool must be guided by the evaluator's expertise and objective.

Trial Registration: Systematic review registered in PROSPERO (CRD42022312143)