Hand function assessment in peritoneal dialysis patient: a pilot study.

Abstract

There is variability among centres regarding the utilization of assisted peritoneal dialysis (PD). Functional impairment is one of the leading causes of assisted PD. Tools to assess the patient's ability to manipulate PD devices are required. The objective of this study was to evaluate the feasibility of hand function evaluation in PD patients and to test the association between hand function estimation and assisted PD. This was a pilot study of adults treated with PD in a dialysis unit in January 2019. Hand function was evaluated by Purdue Pegboard, Jebsen, Jamar and pinch tests. Relative risks were calculated with a Cox model to evaluate the association between each test and assisted PD. Among the 43 PD patients included, 16 were autonomous and 27 were assisted in performing dialysis. The Jebsen and Purdue Pegboard tests were completed by 41 patients (95.3%). All patients succeeded in performing the Jamar and pinch tests. The median time to complete all tests was 22min. After adjustment based on the Charlson comorbidity index, the assembly test of the Purdue Pegboard (RR 0.92 [95% confidence interval (CI) 0.86-0.98]), total Jebsen (RR 1.01 [95% CI 1.00-1.01]) and Jamar test (RR 0.94 [95% CI 0.90-0.99] with the dominant hand; OR 0.94 [95% CI 0.88-0.98] with the non-dominant hand) scores were associated with assisted PD. The evaluation of hand function of PD patients is feasible in daily practice using the Jebsen, Purdue Pegboard, pinch and Jamar tests and may support choosing the appropriate utilization of assisted PD.