Associations between the measures of physical function, risk of falls and the quality of life in haemodialysis patients: a cross-sectional study

Abstract

Background: Impaired physical function due to muscle weakness and exercise intolerance reduces the ability to perform activities of daily living in patients with end-stage kidney disease, and by consequence, Health-Related Quality of Life (HRQoL). Furthermore, the risk of falls is an aggregate of physical function and, therefore, could be associated with HRQoL as well. The present study examined the associations between objective and subjective measures of physical function, risk of falls and HRQoL in haemodialysis patients. Methods: This cross-sectional multicentre study included patients on maintenance haemodialysis. Physical function (quadriceps force, handgrip force, Sit-to-Stand, and six-minute walking test), the risk of falls (Tinetti, FICSIT-4, and dialysis fall index) and HRQoL (PROMIS-29 and EQ-5D-3 L) were measured and analysed descriptively, by general linear models and logistic regression. Results: Of the 113 haemodialysis patients (mean age 67.5 ± 16.1, 57.5% male) enrolled, a majority had impaired quadriceps force (86.7%) and six-minute walking test (92%), and an increased risk of falls (73.5%). Whereas muscle strength and exercise capacity were associated with global HRQoL (R 2 = 0.32) and the risk of falls, the risk of falls itself was related to psycho-social domains (R 2 = 0.11) such as depression and social participation, rather than to the physical domains of HRQoL. Objective measures of physical function were not associated with subjective fatigue, nor with subjective appreciation of health status. Conclusions: More than muscle strength, lack of coordination and balance as witnessed by the risk of falls contribute to social isolation and HRQoL of haemodialysis patients. Mental fatigue was less common than expected, whereas, subjective and objective physical function were decreased.

Markers of protein-energy wasting and physical performance in haemodialysis patients: A cross-sectional study

“…The physical examinations included the following: (1) The Frailty and Injuries Cooperative Studies of Intervention Technique (FICSIT) was used to examine static balance (time) based on seven positional challenges; i.e. eyes open and closed with feet closely together, semi-tandem and full tandem stand and standing on the dominant leg with eyes open [25]; (2) The Tinetti test is considered the gold standard for examining gait dysfunctions based on 7 items: the initiation of gait, step length and height, step symmetry, step continuity, distinguished path, trunk and walking stance [26]. Patients scoring < 11 on 12 on the Tinetti test are considered to be at a higher risk of falls [27]; (3) For the five repetition Sit-to-Stand test (STS), patients were instructed to get from a seated to a standing position for 5 times as rapidly as possible with their arms folded across the chest [28].…”

“…Physical impairments and haemodialysis (HD) therapy itself are major barriers for physical activity in patients with end-stage kidney disease (ESKD) [1,2]. Physical inactivity leads to a high risk for cardiovascular (CV) disease and results in a more extensive deterioration of physical performance [3].…”

Orthotic Research Initiative for Outcomes aNalysis (ORION I): predictors of PROMIS PF for stroke survivors seeking orthotic intervention

“…Backward stepwise regression was used to estimate the model that best predicts PF among AFO users. Hypothesized predictors of PF were selected a priori based on previous studies utilizing self-reported measures of PF [24][25][26][27][28][29][30][31]. The six factors were: gender, age, pain, fall history, AFO history, and ankle mobility.…”

Depressão E Qualidade De Vida Em Pacientes Dialíticos

“…Em pacientes dialíticos, pode ser usado na promoção de saúde e controle de comorbidades, além de ajudar no controle de distúrbios motores e de equilíbrio. As intervenções para promover a qualidade de vida relacionada à saúde em pacientes com doença renal terminal devem focar na promoção da atividade física e no cuidado com a saúde mental do paciente, como descrito por López et al 8,10,15,19 .…”