Is there a relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients?

Abstract

Introduction: This study was conducted to investigate the relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients. Materials and Methods: The study involved 24 hemodialysis patients and 20 healthy volunteers. Light touch‐pressure sensation (Semmes Weinstein Monofilament test kit), two‐point discrimination sensation (esthesiometer) and vibration sensation (128 Hz diapason) were used to evaluate plantar foot sensation. Static balance was assessed by the one‐leg standing balance test, physical performance by the Timed Up and Go test, fear of falling with the Fall Efficacy Scale, and quality of life with the Ferrans and Powers Quality of Life Index Dialysis Version. Findings: There was a significant difference in plantar foot sensation, static balance, and physical performance of the patients compared to the healthy controls (P < 0.05). There was a strong correlation between static balance and physical performance with foot sensation in the hemodialysis patients (P < 0.05). There was also a strong correlation between static balance, physical performance, and fear of falling in hemodialysis patients (P < 0.05). The correlation between static balance, physical performance, and quality of life in the hemodialysis patients was strong (P < 0.05). Discussion: The most important result of this study is that light touch‐pressure sensation, vibration sensation, two‐point discrimination sensation, static balance, and physical performance, all of which involve the activity of cutaneous sensory receptors on the sole of the foot, are reduced in individuals who undergo hemodialysis. The findings of this study suggest potential rehabilitation strategies that could be applied to this patient group.

Association between fear of falling and a history of falls in patients with end‐stage renal disease on hemodialysis

“…The association between FOF and a history of falls was also found in patients with chronic obstructive pulmonary disease [20], patients with multiple sclerosis [21] and elderly patients [22]. Some factors that contribute to falls in patients on hemodialysis may explain the association between FOF and a history of falls in these patients, such as functional impairment, frailty and postural balance alterations [5,14]. In a recent study with 131 ESRD patients undergoing hemodialysis, it was observed that difficulty walking and frailty increased the chance of reporting high concern about falling by 4.74 and 2.47 times, respectively [5].…”

“…In a recent study with 131 ESRD patients undergoing hemodialysis, it was observed that difficulty walking and frailty increased the chance of reporting high concern about falling by 4.74 and 2.47 times, respectively [5]. In another study with patients on hemodialysis, the authors observed an association between FOF, assessed by the FES-I, and postural balance and physical performance [14]. Moreover, Billis et al [23] observed lower FES-I scores in elderly people with one fall event than in those with two or more fall events in a 12-month interval (24.8 ± 5.3 vs. 31.1 ± 10.9), which demonstrates the relationship between the number of falls and FOF.…”

“…In this context, a relevant aspect is fear of falling (FOF), defined as the level of confidence in performing activities of daily living without falling [11]. This condition, frequently assessed by the Fall Efficacy Scale-International (FES-I) [12][13][14], contributes to a vicious cycle of physical inactivity and worsening physical function that increases the risk of falling. Furthermore, FOF has been associated with difficulty walking, poorer physical performance and restrictions on activities of daily living in patients on hemodialysis [6,[14][15][16].…”

“…This condition, frequently assessed by the Fall Efficacy Scale-International (FES-I) [12][13][14], contributes to a vicious cycle of physical inactivity and worsening physical function that increases the risk of falling. Furthermore, FOF has been associated with difficulty walking, poorer physical performance and restrictions on activities of daily living in patients on hemodialysis [6,[14][15][16]. However, the association between FOF and a history of falls remains underexplored in ESRD patients, and knowledge of this association could assist in the application of necessary interventions to prevent falls in this population.…”

Validity and Reliability of Criteria for Plantar Sensation Assessment Using Semmes–Weinstein Monofilament as a Clinically Usable Index

“…Physiological and pathological aging related to this function increases the risk of falls [ 4 ]. Strong correlation between plantar sensation and static balance in hemiplegic patients has been previously suggested [ 5 ], and that stimulation of plantar sensation could improve static balance [ 6 ]. However, data on the therapeutic exercises that effectively improve this function remain limited.…”