Signatures of Gait Movement Variability in CKD Patients Scheduled for Hemodialysis Indicate Pathological Performance Before and After Hemodialysis: A Prospective, Observational Study

Frontiers in Medicine

article

Damiano D. Zemp¹  Olivier Giannini³  Pierluigi Quadri²  Marco Rabuffetti⁵  Mauro Tettamanti⁶  Eling D. de Bruin¹ 

[1] Department of Health Sciences and Technology, Institute of Human Movement Sciences and Sport;Ospedale Regionale della Beata Vergine;Department of Internal Medicine;Faculty of Biomedical Sciences, Università della Svizzera Italiana;IRCCS Fondazione Don Carlo Gnocchi;Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCSS;Department of Neurobiology, Care Sciences and Society, Karolinska Institute;OST – Eastern Swiss University of Applied Sciences, Department of Health

关键词: chronic kidney disease;    end stage renal disease;    hemodialysis;    physical activity;    gait;    variability;    dual-task costs;   

DOI  :  10.3389/fmed.2021.702029

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Background: The frailty status of hemodialysis patients is well-known, but the role of the therapy in the frailty process is not yet clear. Nowadays gait analysis in nephrology is neglected, although gait performance is known to be related to frailty and kidney function. We hypothesized that gait quality and physical activity level is already affected before, and does not change because of the start of hemodialysis. Methods: Fourteen patients (72.3 ± 5.7 years old) in a pre-dialysis program underwent an instrumental gait analysis and their physical activity was monitored for a week. This protocol was repeated 3, 6, 12, and 24 months after the first hemodialysis session. Results: At baseline, our sample showed a conservative gait with pathologic gait variability, high dual-task cost, and a sedentary lifestyle. No statistically significant change was found in any parameter in the analyzed period, but there was a tendency toward an improvement of gait quality and physical activity in the first year of treatment, and a decline in the second year. Conclusion: Elderly patients in the pre-dialysis stage show a conservative gait, however variability was in a pathological range and did not change post-hemodialysis. This hints toward changes in the central nervous system due to the kidney disease. This finding suggests the importance of gait analysis in the early stages of renal disease in the diagnosis of changes in the nervous system due to kidney failure that affect gait. Early detection of these changes would potentially allow a prevention program tailored to this population to be developed.

【 授权许可】

CC BY