Influences on the Performance based Frailty of Physical Performance, Exercise Self-efficacy, Decisional Balance, and Health related Quality of Life in Adults Undergoing Hemodialysis

Abstract

Purpose: This study was to examine the relationships among frailty, physical performance, exercise self-efficacy, decisional balance, and health-related quality of life (HRQoL) and to identify the impact factors on frailty in adults undergoing hemodialysis. Methods: In this cross-sectional study, 96 adults (41 women, 55 men, age 57.10±13.56 years) were enrolled an university hospital-affiliated outpatient hemodialysis clinic. Participants were asked to administer questionnaires including exercise change stages, exercise self-efficacy, decisional balance, and HRQoL. Participants also completed measures of the short battery physical performance test (SPPB), usual gait speed, grip strength (JAMAR Hand Dynamometer, Paterson medical Ltd. Warrenville, USA), and body composition (Inbody S10, Biospace company, Seoul, Korea). Frailty status was classified according to the frailty phenotype developed by Fried using gait speed, grip strength, vitality from mental HRQoL, physical activity from exercise change stages, and body mass index. Results: According to frailty scores, 56.3% (n=54) were frail (frailty scores 3-5) and 43.7% were non-frail (frailty scores 0-2). Exercise self-efficacy, pros decisional balance, and HRQoL were lower in the frail patients (all p<.05). Frailty correlated with worse scores of SPPB (r=-.56), exercise self-efficacy (r=-.40), pros decisional balance (r=-.24), and physical and mental HRQoL (r=-.32; r=-.26) by Spearman correlation analysis. Factors associated with non-frailty includes higher SPPB (odds ratio: 1.67, 95% confidence interval: 1.15~2.44) and exercise self-efficacy (odds ratio 1.17, 95% confidence interval: 1.03~1.33). Conclusion: A targeted management program based on the frailty stage may benefit individuals undergo hemodialysis.

Effects of an arteriovenous fistula stenosis prevention program in patients receiving hemodialysis

“…In previous studies on exercise therapy for dialysis patients, simple repetitive motion exercises using rubber balls [ 15 , 21 ], rubber bands [ 22 ], and grippers [ 23 ] were predominant. However, muscle exercise using a gripper is more effective in increasing the venous size and blood flow of an AVF than simple repetitive training using a rubber ball with low elasticity [ 24 ].…”