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

Anuradha Sawant,Tom Overend

doi:10.3390/healthcare5040092

Anuradha Sawant, Tom Overend

Open Access

https://doi.org/10.3390/healthcare5040092

Copy DOI

Journal: Healthcare	Publication Date: Dec 5, 2017
Citations: 4	License type: CC BY 4.0

Affiliation: London Health Sciences Centre, Western University

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.

Highlights

Chronic kidney disease is the progressive failure of renal function over a period of years
The presence of neurogenic, myogenic, and mixed changes intrinsic to the skeletal muscle in people with end-stage kidney diseases (ESKD) on HD [3] may further compromise the integrity of the motor-unit complex and contribute to muscle atrophy [4]
The results of this systematic review confirm the earlier findings of reduced gait speed (GS) and distance walked in six minutes by participants on HD in the literature

Summary

Introduction

Chronic kidney disease is the progressive failure of renal function over a period of years. The presence of neurogenic (muscle atrophy or loss associated with nerve disorder), myogenic (damage intrinsic to the muscle), and mixed (neurogenic and myogenic) changes intrinsic to the skeletal muscle in people with ESKD on HD [3] may further compromise the integrity of the motor-unit complex and contribute to muscle atrophy [4]. As a result, such changes can lead to overall decreases in gait and mobility [5]. 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)

Objectives

Methods

Results

Conclusion