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Muscle strength, mobility, quality of life and falls in patients on maintenance haemodialysis: A prospective study

TitleMuscle strength, mobility, quality of life and falls in patients on maintenance haemodialysis: A prospective study
Publication TypeJournal Article
Year of Publication2017
AuthorsWang, A, Sherrington, C, Toyama, T, Gallagher, M, Cass, A, Hirakawa, Y, Li, Q, Sukkar, L, Snelling, P, Jardine, M
JournalNephrology (Carlton)
Volume22
Issue3
Pagination220-7
Date Published03/2017
ISBN Number1440-1797 (Electronic)<br/>1320-5358 (Linking)
Accession Number26890468
Abstract

AIM: To explore i) the relationship between quality of life (QOL) and physical parameters (muscle strength and mobility) among people undergoing maintenance haemodialysis, ii) changes in strength and mobility over time and predictors of changes and iii) whether strength and mobility were associated with falls. METHODS: We recruited 51 maintenance haemodialysis patients to a prospective longitudinal study. Baseline QOL was assessed using the SF-36 physical (PCS) and mental component summary scores (MCS). Muscle strength (ankle dorsiflexion strength measured with a hand held dynamometer), mobility (Short Physical Performance Battery, SPPB) and falls history were assessed at baseline, 12 and 36 months. Associations between variables at baseline were assessed with linear regression models. Changes in physical parameters were evaluated with paired T-tests and prediction of falls assessed by negative binominal regression. RESULTS: Fifty and 34 patients completed 12 and 36 month follow-ups respectively. Baseline mobility but not muscle strength correlated with PCS (P = 0.01 and P = 0.23 respectively). Neither correlated with MCS. At 12-months, muscle strength and mobility had significantly deteriorated (mean AS 11.0 lb (SD 1.5) from 14.0 lb (SD 2.2), P < 0.01; SPPB 8.5 (SD 2.8) from 9.3 (SD 2.6), P < 0.01). Falls at 12 and 36 months were predicted by baseline mobility (P = 0.06 and P = 0.02 respectively) but not muscle strength. CONCLUSION: Physical parameters appear to be associated with meaningful patient outcomes and showed measurable deterioration over relatively short time frames. Interventions, with the potential to slow physical decline in people receiving maintenance dialysis, such as exercise programs, warrant further investigation. This article is protected by copyright. All rights reserved.

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