Objectives
To undertake balance and functional mobility assessments in older maintenance haemodialysis patients before and after haemodialysis
as a pilot study in order to gain initial data and to assess the feasibility and acceptability of this type of study.
Design
Postural sway, three-metre timed “up and go” test (TGUGT), and dynamic single leg extensor power (LEP) were measured before
and after a haemodialysis session.
Setting and subjects
Male and female maintenance haemodialysis patients aged over 60 years attending the Nottingham City Hospital.
Main measures
Objective outcome measures were postural sway number and sway path (mm) by balance performance monitor, timed three-metre
“up and go” test (s), and leg extensor power (W). Blood pressure and weight reductions were also measured. Subjective assessments
of practicality and acceptability were made.
Results
Twenty-two patients enrolled. Complete data sets were collected for 14 subjects (11 male, three female). Results were analysed
using the Wilcoxon signed ranks test for nonparametric data. There was no significant difference before and after dialysis
in postural sway, timed “up and go” or leg extensor power. Eight patients did not complete the study and the reasons are examined.
Conclusions
There was no significant single-session effect. Results suggest that haemodialysis patients may be weaker and have reduced
postural stability when compared to historical data on comparable undialysed patients. The study was logistically complex
and would be difficult to expand using these methods, but the issues merit further consideration.
Keywords Balance - End-stage renal disease - Falls - Functional status - Haemodialysis - Older adults, elderly - Performance assessment - Pilot study - Postural stability - Strength