Functional capacity of haemodialysis patients assessed for the first time

Over 2 million people receive haemodialysis treatment worldwide. Their physical condition is affected by hours of forced physical inactivity while they receive the treatment several times a week, exacerbated by muscular atrophy derived from chronic kidney disease. This affects activities such as walking or standing up from a chair. Several studies have shown the efficacy of exercise during haemodialysis sessions. Now, a team headed by Professor Eva Segura has evaluated three physical condition tests that are typically used to study exercise during haemodialysis to determine their suitability for these patients.

The results have been published in PLOS One. This study is part of the reliability research conducted on physical condition tests for haemodialysis patients published in Physical Therapy in 2011.

This new research involved 71 patients of the haemodialysis units of the Hospital de Terrassa and the Hospital Universitario Doctor Peset in Valencia, who have been receiving haemodialysis sessions for at least three months. Their functional capacity and mobility levels have been assessed with three tests, the repeatability of which had never yet been tested in haemodialysis patients.

The first of the tests, known as the Short Physical Performance Battery, evaluates the functionality of the lower limbs with tests that measure balance, normal gait speed and the ability to rise from a chair. The One-Legged Stance Test measures the ability to remain standing on one leg, and the Timed Up and Go test evaluates the time needed to stand up, walk three meters, walk back and sit down again.

Physical condition and dialysis sessions

Lucía Ortega, author of the thesis, says, “No prior research had determined the reliability of these tests in patients subjected to haemodialysis to evaluate their functional mobility and the risks of low physical condition, the probability of falling. Nor had the minimum change values been established, which should alert doctors on functionality issues for this type of patient. Doctors could then apply measures to contribute to the improvement of their physical condition as soon as possible. We must not forget that these are patients who spend several hours lying down, both during the haemodialysis sessions, and during the recovery period afterwards, and several days a week, which affects their physical condition and can have consequences on their health.”

The results of the research show the high reliability of these three functional mobility tests for patients undergoing haemodialysis sessions for a chronic kidney disease in the terminal stage, and establish values for detecting relevant variations in the clinical field.

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