Postural stability during standing and its association with physical and cognitive functions in non-dialysis chronic kidney disease patients

Wilkinson, Thomas J; Nixon, Daniel; Smith, Alice C.

doi:10.1007/s11255-019-02192-4

Cited by 18 publications

(10 citation statements)

References 29 publications

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“…After controlling for covariates, the cognitively impaired group was found to have significantly slower gait speed, highlighting the potential for co-occurrence of physical and cognitive symptoms, even in predialysis patients (Otobe et al, 2019). Similarly, in a cross-sectional study, Wilkinson and colleagues (2019) found that poorer postural stability was strongly correlated with lower MOCA-Basic scores in a population of nondialysis CKD patients ( N = 30, M age = 57). Overall, screening for cognitive impairment in this population is important given the risk for association with adverse health variables.…”

Section: Results Of Scoping Reviewmentioning

confidence: 77%

Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: A scoping review.

Carlew¹,

Smith²,

Goette³

et al. 2021

Health Psychology

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Objective: The purpose of this review is to critically examine studies that have examined investigated the Montreal Cognitive Assessment (MoCA) and functional or medical outcomes and other health variables in patients with non-neurologic medical conditions. Method: Databases OVID Medline and Embase were systematically searched through April 2020, yielding 281 articles that were separately screened for inclusion. Study characteristics extracted from retained articles are presented in Table S1 (online supplemental materials). Results: Thirty-six articles were retained. Cognitive impairment as assessed by the MoCA was associated with adverse health variables including increased morbidity/mortality, poorer functional abilities, increased length of hospital stay, and increased hospital readmissions in 34 of 36 articles. Conclusions: Cognitive impairment as detected by the MoCA was shown in 34 of 36 studies to be associated with worse functional or medical status compared to those with better cognitive functioning across a variety of medical populations. Further research is needed to better understand how to best use the MoCA to potentially inform treatment planning in medical populations, including referral for more detailed neuropsychological evaluation.

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Section: Results Of Scoping Reviewmentioning

confidence: 77%

Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: A scoping review.

Carlew¹,

Smith²,

Goette³

et al. 2021

Health Psychology

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“…Better functional capacity is indicated by a quicker time 21 . Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter device that measures force distribution and resultant centre of pressure (COP) displacement 22 . Patients stood bipedal on the board with their feet shoulder‐width apart and their eyes open.…”

Section: Methodsmentioning

confidence: 99%

Muscle power and physical dysfunction: A model for tailoring rehabilitation in chronic kidney disease

et al. 2021

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Introduction: Chronic kidney disease (CKD) is characterized by adverse physical function. Mechanical muscle power describes the product of muscular force and velocity of contraction. In CKD, the role of mechanical muscle power is poorly understood and often overlooked as a target in rehabilitation. The aims of this study were to investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method: Mechanical muscle power was estimated using the sit-to-stand-5 test. Legs lean mass was derived using bioelectrical impedance analysis. Physical performance was assessed using gait speed and 'timed-up-and-go' (TUAG) tests. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index. Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low levels of power.Results: One hundred and two non-dialysis CKD participants were included (age: 62.0 (±14.1) years, n = 49 males (48%), eGFR: 38.0 (±21.5) ml/min/1.73m 2 ). The mean relative power was 3.1 (±1.5) W/kg in females and 3.3 (±1.3) W/kg in males. Low relative power was found in 34% of patients. Relative power was an independent predictor of ADLs (β = .413, p = .004), and TUAG (β = À.719, p < .001) and gait speed (β = .404, p = .003) performance. Skeletal muscle mass was not associated with any outcomes. Conclusion:Knowledge of the factors that mediate physical function impairment is crucial for developing effective interventions. Incorporation of power-based training focusing primarily on movement velocity may present the best strategy for improving physical function in CKD, above those that focus on increasing muscle mass.

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“…Postural stability and balance will be assessed using a previously reported method 72 with a FysioMeter device (modified Nintendo Wii balance board (Nintendo, Kyoto, Japan)) connected via Bluetooth to software on a portable computer (FysioMeter, Brønderslev, Denmark). Total centre of pressure ellipse area (mm 2 ) will be obtained.…”

Section: Methods and Analysismentioning

confidence: 99%

A pilot randomised controlled trial of a structured, home-based exercise programme on cardiovascular structure and function in kidney transplant recipients: the ECSERT study design and methods

et al. 2021

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BackgroundCardiovascular disease (CVD) is a major cause of morbidity and mortality in kidney transplant recipients (KTRs). CVD risk scores underestimate risk in this population as CVD is driven by clustering of traditional and non-traditional risk factors, which lead to prognostic pathological changes in cardiovascular structure and function. While exercise may mitigate CVD in this population, evidence is limited, and physical activity levels and patient activation towards exercise and self-management are low. This pilot study will assess the feasibility of delivering a structured, home-based exercise intervention in a population of KTRs at increased cardiometabolic risk and evaluate the putative effects on cardiovascular structural and functional changes, cardiorespiratory fitness, quality of life, patient activation, healthcare utilisation and engagement with the prescribed exercise programme.Methods and analysisFifty KTRs will be randomised 1:1 to: (1) the intervention; a 12week, home-based combined resistance and aerobic exercise intervention; or (2) the control; usual care. Intervention participants will have one introductory session for instruction and practice of the recommended exercises prior to receiving an exercise diary, dumbbells, resistance bands and access to instructional videos. The study will evaluate the feasibility of recruitment, randomisation, retention, assessment procedures and the intervention implementation. Outcomes, to be assessed prior to randomisation and postintervention, include: cardiac structure and function with stress perfusion cardiac MRI, cardiorespiratory fitness, physical function, blood biomarkers of cardiometabolic health, quality of life and patient activation. These data will be used to inform the power calculations for future definitive trials.Ethics and disseminationThe protocol was reviewed and given favourable opinion by the East Midlands-Nottingham 2 Research Ethics Committee (reference: 19/EM/0209; 14 October 2019). Results will be published in peer-reviewed academic journals and will be disseminated to the patient and public community via social media, newsletter articles and presentations at conferences.Trial registration numberNCT04123951.

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Postural stability during standing and its association with physical and cognitive functions in non-dialysis chronic kidney disease patients

Cited by 18 publications

References 29 publications

Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: A scoping review.

Montreal Cognitive Assessment (MoCA) scores in medically compromised patients: A scoping review.

Muscle power and physical dysfunction: A model for tailoring rehabilitation in chronic kidney disease

A pilot randomised controlled trial of a structured, home-based exercise programme on cardiovascular structure and function in kidney transplant recipients: the ECSERT study design and methods

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