Walking and Talking in Maintenance Hemodialysis Patients

Abstract

ObjectivesTo investigate whether there is a reduction in walking with the simultaneous performance of a cognitive task (ie, dual-task cost [DTC]) in persons undergoing hemodialysis (HD), and whether it is greater in persons undergoing HD compared with age-matched controls. DesignCohort. SettingUniversity research laboratory. ParticipantsPersons undergoing HD (n=14; 5 women, 9 men; mean age ± SD, 50.0±11.8y) and age-matched controls (n=14; 4 women, 10 men; mean age ± SD, 48.5±10.1y) participated in the investigation. InterventionsNot applicable. Main Outcomes MeasuresParticipants walked at a self-selected pace on an electronic pathway, which recorded spatiotemporal parameters of gait, in 4 separate trials and completed a cognitive task in the last 2 trials. The DTC was quantified as the change in spatiotemporal parameters of gait from baseline to the cognitive trials. ResultsThe HD group had a greater decrease in walking function during the cognitive task, with DTC ranging from 6% to 14%. On average, walking velocity decreased to less than 1m/s in HD patients during the cognitive condition. Baseline walking velocity was found to be moderately correlated with the magnitude of DTC of cadence and step time (ρ=−.44 and .46; P values <.05). ConclusionsPersons undergoing HD have greater interference between walking and talking compared with controls. Difficulty walking while thinking has implications for everyday life and may be related to the risk of falls. Further work is necessary to determine other contributing factors to elevated DTC in HD patients, and whether DTC can be reduced with targeted interventions.