Abstract
BackgroundHemodialysis (HD) patients are at a high risk of falls and fractures. The amount of physical activity (PA) they perform may be limited by psychosomatic factors associated with fear of falling, leading to frailty progression. This study aimed to clarify the relationship between fear of falling and PA in patients undergoing HD.MethodsThis cross-sectional study included 46 HD patients. Fear of falling was evaluated using the Modified Falls Efficacy Scale (MFES). A 3-axis accelerometer was used to measure PA, including number of steps; 1 to 1.9 METs = static PA, 2 to 2.9 = light PA, and 3 or more = moderate to vigorous PA (MVPA). We examined correlation of MFES with each type of PA. Factors affecting fear of falling were determined using multiple regression analysis.ResultsThe median MFES was 9.2 (7.4, 10.0). MFES was associated with the number of steps (r = 0.608, p < 0.001), light PA (r = 0.421, p = 0.004), and MVPA (r = 0.546, p < 0.001). Eighteen participants (39.1%) experienced at least one fall in a year and had lower MFES than the non-fall group (fall group: 7.4 [5.1, 9.0] vs. non-fall group: 9.7 [8.5, 10.0], p < 0.001). Multiple regression analysis showed that MFES was independently associated with the number of steps (B = 279.7, 95% confidence interval [CI] = 90.5–469.0, p = 0.005) and MVPA (B = 3.52, 95% CI = 1.14–5.90, p = 0.005), respectively.ConclusionsFear of falling was associated with amount of PA among patients undergoing HD. Interventions that target the fear of falling may be effective in reducing HD patients’ fall risk by enhancing PA.
Highlights
Hemodialysis (HD) patients are at a high risk of falls and fractures
Among older adults, reduced physical activity (PA) is associated with both falls and fractures [4], while HD patients may have poor PA owing to sarcopenia/frailty and dialysis treatment
Sex, height, dry weight (DW), body mass index (BMI), dialysis duration, primary cause of kidney disease, presence of comorbidities, Charlson comorbidity index (CCI), serum albumin level, blood pressure, Kt/v for urea, blood hemoglobin level, and serum intact parathyroid hormone (PTH) levels were reported as basic characteristics
Summary
Hemodialysis (HD) patients are at a high risk of falls and fractures. The amount of physical activity (PA) they perform may be limited by psychosomatic factors associated with fear of falling, leading to frailty progression. Hemodialysis (HD) patients experience fractures more frequently than healthy individuals [1, 2]. HD patients frequently experience falls that induce fractures [3]. Among older adults, reduced physical activity (PA) is associated with both falls and fractures [4], while HD patients may have poor PA owing to sarcopenia/frailty and dialysis treatment. Fear of falling is a psychological state as ongoing concern about falling that leads to avoidance of the performance of daily activities [6]. Severe fear of falling restricts activity of daily living and PA even if patients have enough physical functions. The modified falls efficacy scale (MFES) is one of psychological parameters used to evaluate associated fall risk in the general population [7] while there is little data for MFES in HD patients
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
