Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

Abstract

Only walking velocity has been reported as a performance measure of gait in hemodialysis patients, and no kinematic or kinetic analysis has been reported. We evaluated basic information, physical function, aging, dialysis-related complications, and gait in 23 outpatients (≥60 years old) who could walk independently. Hierarchical cluster analysis was performed using joint angles, joint moments, and gait parameters during gait. The gait of hemodialysis patients was classified into two clusters: Cluster 1 and Cluster 2. Cluster 1 gait showed a longer hemodialysis duration, higher dialysis amyloidosis severity, knee joint pain, lower ankle plantarflexion weakness, and lower extremity joint dysfunction than Cluster 2. The gait of Cluster 1 patients consisted of flexion of the knee joint, ankle joint, and trunk, and excessive knee joint flexion was observed in the stance phase to escape posterior knee joint pain. Cluster 1 patients were also unable to kick out sufficiently, and their walking rate and walking velocity were decreased. Cluster 2 patients had a shorter hemodialysis duration than Cluster 1. External forces exerted on the knee joint in the hyperextension direction during gait could cause pain and inflammation of the posterior knee joint.