Test-retest reliability and minimal detectable change scores for the short physical performance battery, one-legged standing test and timed up and go test in patients undergoing hemodialysis

Lucía Ortega-Pérez De Villar,Francisco José Martínez-Olmos,Javier Martínez-Gramage,Tom Mercer,Eva Segura-Ortí,Anna Junqué-Jiménez,Juan José Amer-Cuenca,Gianpaolo Reboldi

doi:10.1371/journal.pone.0201035

Lucía Ortega-Pérez De Villar, Francisco José Martínez-Olmos + Show 6 more

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https://doi.org/10.1371/journal.pone.0201035

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Abstract

Functional tests are commonly used for chronic kidney disease (CKD) patients undergoing hemodialysis (HD). However, the relative and absolute reliability of such physical performance-outcome assessments must first be determined in specific patient cohorts. The aims of this study were to assess the relative and the absolute reliability of the Short Physical Performance Battery (SPPB), One-Legged Stance Test (OLST), and Timed Up and Go (TUG) test, as well as the minimal detectable change (MDC) scores for these tests in CKD patients receiving HD. Seventy-one end-stage CKD patients receiving HD therapy, aged between 21 and 90 years, participated in the study. The patients completed two testing sessions one to two weeks apart and performed by the same examiner, comprising the following tests: the SPPB (n = 65), OLST (n = 62), and TUG test (n = 66). High intraclass correlation coefficients (≥0.90) were found for all the tests, suggesting that their relative reliability is excellent. The MDC scores for the 90% confidence intervals were as follows: 1.7 points for the SPPB, 11.3 seconds for the OLST, and 2.9 seconds for the TUG test. The reliability of the SPPB, OLST, and TUG test for this sample were all considered to be acceptable. The MDC data generated by these tests can be used to monitor meaningful changes in the functional capacity of the daily living-related activity of CKD patients on HD.

Highlights

Renal failure is a common problem with more than two million people worldwide were being treated by dialysis because of chronic kidney disease (CKD) [1]
According to the EPIRCE (Epidemiology in Chronic Renal Failure in Spain) study, 10% of the Spanish adult population suffers from some form of renal failure, with 6.8% presenting stage 3–5 CKD; in 2010, this meant that approximately 4 million people in Spain suffered from CKD requiring renal replacement treatment [2]
The activity level of the sample according to the human activity profile adjusted activity score was low, with a mean score below 53

Summary

Introduction

Renal failure is a common problem with more than two million people worldwide were being treated by dialysis because of chronic kidney disease (CKD) [1]. According to the EPIRCE (Epidemiology in Chronic Renal Failure in Spain) study, 10% of the Spanish adult population suffers from some form of renal failure, with 6.8% presenting stage 3–5 CKD; in 2010, this meant that approximately 4 million people in Spain suffered from CKD requiring renal replacement treatment [2]. Hemodialysis (HD) is the most common renal replacement treatment, but other possibilities include peritoneal dialysis or kidney transplantation. The latter is especially desirable as a definitive treatment, given that patients on long-term HD have high levels of comorbidity (mainly cardiovascular problems) and physical function problems [3]. Various authors have reported the functional properties of these tests for several sample groups, especially in elderly populations, but these tests remain insufficiently studied in CKD groups [5,6,7,8,9,10,11,12,13,14,15,16,17,18]

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