The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review

Abstract

Background: People with end-stage kidney disease (ESKD) on hemodialysis (HD) commonly have functional impairments. The purpose of this systematic review was to evaluate the effect of HD on spatio-temporal characteristics of gait, and effect of exercise on these parameters. Methods: Electronic databases were searched to identify relevant citations. Extracted data was computed using a random effects model for means (Hedges’ and 95% confidence interval (CI). Results: 27 studies met inclusion criteria. Mean values: gait speed (GS)—1.0 m/s (CI: 0.9–1.1 m/s; 16 studies), fast walking speed (FWS)—1.5 m/s (CI: 1.3–1.6 m/s; 7 studies), timed get-up & go test (TUG) —6.8 s (CI: 6.1–7.5 s; 2 studies), walk tests (WT) 193.0 s (CI: 116.0–270.0; 5 studies), 6 min-walk-test (6MWT)—386.6 m (CI: 243.2–530.0 m; 11 studies). 4 studies compared participants on HD with normal controls and 10 studies evaluated the effect of nutrition/exercise. Conclusions: Compared to age-matched populations, people with ESKD/HD had significantly slower GS and reduced walk distances; with intervention, the change in the distance walked was significant. Further research is required to evaluate the effect of HD on gait parameters, and the type of exercise/nutrition that will lead to meaningful changes.

Kinematic and Kinetic Analysis of Gait in Maintenance Hemodialysis Patients

“…The walking velocity of the hemodialysis group was 1.14 ± 0.18 m/sec, and the walking rate was 119.9 ± 10.1 steps/min. Previous studies of the walking parameters of hemodialysis patients reported that the walking velocity was 1.01 m/s [29], and the walking rate was 100.1 ± 12.6 steps/min [30]. In our hemodialysis group, the walking velocity was relatively maintained, and the walking rate was higher.…”

Effects of intradialytic exercise for advanced-age patients undergoing hemodialysis: A randomized controlled trial

“…Exercise therapy improves physical function in older patients undergoing dialysis, but the mechanism of benefit may differ from that in middle-aged patients. Previous studies have indicated that exercise therapy for middle-aged hemodialysis patients improved muscle strength [8,31] and the 10-m walking speed [32]. The effect of exercise therapy for advanced-age patients undergoing hemodialysis, as compared with the effect on middle-aged patients, differs across studies.…”

Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

“…The gait of Cluster 1 had been on hemodialysis for a longer duration than Cluster 2, was an inflection at the knee joint, ankle joint, and trunk, and the ankle joint plantarflexion moment in Cluster 1 was small at toe-off, resulting in inadequate kicking and a reduced walking rate and walking velocity. The walking velocity of hemodialysis patients was lower than that of the same age group, with a reported walking velocity of 1.01 m/s [27] and a walking rate of 100.1 ± 12.6 steps /min [28].…”