The effect of hemodialysis on balance measurements and risk of fall

Erken, Ertuğrul; Özelsancak, Rüya; Sahin, Şevki; Yılmaz, Emine Ece; Torun, Dılek; Leblebici, Berrin; Kuyucu, Yunus Emre; Sezer, Sıren

doi:10.1007/s11255-016-1388-7

Cited by 32 publications

(31 citation statements)

References 33 publications

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“…This could have led to an overestimation of the number of geriatric problems. For example, previous research showed that patients had a poorer balance right after dialysis [50]. Therefore, the four test balance scale could be performed worse by patients who did the test after dialysis.…”

Section: Discussionmentioning

confidence: 99%

Geriatric Assessment in Elderly Patients with End-Stage Kidney Disease

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Loon

Morpey

et al. 2018

Nephron

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Background/Aims: Decision-making in elderly patients considering dialysis is highly complex. With the increasing number of elderly with end-stage kidney disease (ESKD), it may be important to assess geriatric impairments in this population. The aim of the Geriatric assessment in OLder patients starting Dialysis (GOLD) study was to assess the prevalence of geriatric impairments and frailty in the elderly ESKD population by means of a geriatric assessment (GA), which is a comprehensive tool for overall health assessment. Methods: This study included 285 patients ≥65 years: 196 patients at the time of dialysis initiation and 89 patients who chose maximal conservative management (MCM). The GA assessed cognition, mood, nutritional status, (instrumental) activities of daily living (ADL), mobility, comorbidity burden, quality of life and overall frailty. Results: The mean age of the participants was 78 years and 36% were women. Of the incident dialysis patients, 77% started haemodialysis and 23% started peritoneal dialysis. Geriatric impairments were highly prevalent in both dialysis and MCM patients. Most frequently impaired geriatric domains in the dialysis group were functional performance (ADL 29%, instrumental ADL (iADL) 79%), cognition (67%) and comorbidity (41%). According to the GA, 77% in the dialysis group and 88% in the MCM group had 2 or more geriatric impairments. In the MCM group, functional impairment (ADL 45%, iADL 85%) was highly prevalent. Conclusions: Geriatric impairments are highly prevalent in the elderly ESKD population. Since impairments can be missed when not searched for in regular (pre)dialysis care, the first step of improving nephrologic care is awareness of the extensiveness of geriatric impairment.

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Section: Discussionmentioning

confidence: 99%

Geriatric Assessment in Elderly Patients with End-Stage Kidney Disease

Goto

Loon

Morpey

et al. 2018

Nephron

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“…It has been proven that individuals who have received hemodialysis experience balance problems, fear of falling, and risk of falling. The study by Erken and Ozelsancak on the static, dynamic balance, and the risk of falling found that losses in static and dynamic balance control were associated with patients being on hemodialysis. It is also said that the problems found in hemodialysis patients do not correlate with age‐related balance losses.…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms include difficulty in climbing stairs, switching from a sitting position to a standing position, and raising the arms . In age‐matched hemodialysis patients, the risk of falling and a loss of balance have been observed, and it has been pointed out that physical performance measurements of hemodialysis patients are crucial because they may be unable to achieve normal physical performances and postural control …”

Section: Introductionmentioning

confidence: 99%

“…Symptoms include difficulty in climbing stairs, switching from a sitting position to a standing position, and raising the arms. [3][4][5] In age-matched hemodialysis patients, the risk of falling and a loss of balance have been observed, [6][7][8] and it has been pointed out that physical performance measurements of hemodialysis patients are crucial because they may be unable to achieve normal physical performances and postural control. [9][10][11][12] In the literature, there is no prior study that has demonstrated the effect(s) of plantar foot sensation on static balance, fear of falling, and physical performance in hemodialysis patients.…”

Section: Introductionmentioning

confidence: 99%

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Is there a relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients?

Erdoğanoğlu

Örs

Külah

et al. 2019

Hemodialysis International

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Introduction: This study was conducted to investigate the relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients. Materials and Methods: The study involved 24 hemodialysis patients and 20 healthy volunteers. Light touch‐pressure sensation (Semmes Weinstein Monofilament test kit), two‐point discrimination sensation (esthesiometer) and vibration sensation (128 Hz diapason) were used to evaluate plantar foot sensation. Static balance was assessed by the one‐leg standing balance test, physical performance by the Timed Up and Go test, fear of falling with the Fall Efficacy Scale, and quality of life with the Ferrans and Powers Quality of Life Index Dialysis Version. Findings: There was a significant difference in plantar foot sensation, static balance, and physical performance of the patients compared to the healthy controls (P < 0.05). There was a strong correlation between static balance and physical performance with foot sensation in the hemodialysis patients (P < 0.05). There was also a strong correlation between static balance, physical performance, and fear of falling in hemodialysis patients (P < 0.05). The correlation between static balance, physical performance, and quality of life in the hemodialysis patients was strong (P < 0.05). Discussion: The most important result of this study is that light touch‐pressure sensation, vibration sensation, two‐point discrimination sensation, static balance, and physical performance, all of which involve the activity of cutaneous sensory receptors on the sole of the foot, are reduced in individuals who undergo hemodialysis. The findings of this study suggest potential rehabilitation strategies that could be applied to this patient group.

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“…[23] A study investigating the effect of hemodialysis on balance found the FI score to be significantly higher after hemodialysis and they emphasized the risk of falling in all age groups of patients with renal insufficiency following hemodialysis. [24] On the other hand, Akdeniz et al [25] highlighted the importance of hypovitaminosis of vitamin D for risk of falling. They found better balance control and decrease FI in patients with serum 25-OH-vitamin D levels higher than 50.0 nmol/L in women aged 60 and above.…”

Section: Discussionmentioning

confidence: 99%

Posturographic examination of body balance in patients with Chiari type I malformation and correlation with the presence of syringomyelia and degree of cerebellar ectopia

Palamar¹

2018

Turk J Phys Med Rehab

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Objectives:We aimed to evaluate balance using the Tetrax Interactive Balance System (TIBS) in patients with Chiari type I malformation (CM-I) and to assess their fall risk with other clinical parameters. Patients and methods:This cross-sectional, prospective study was conducted at physical medicine and rehabilitation outpatient clinics and neurosurgery department of a university hospital between December 2013 and December 2014. The study included a total of 36 patients (31 females, 5 males; mean age 40.6±10.0 years; range, 18 to 60 years) with CM-I. Dynamic balance was assessed using the Berg Balance Scale (BBS), and posturographic examinations were performed using the TIBS. Results:The mean Fall Risk Index (FI) value was 42.4±29.8 and the mean BBS score was 55.5±1.5. The most common complaints were neck pain (94.4%), headache (88.9%), paresthesia (86.1%), fatigue (83.3%), and vertigo (80.6%). The mean tonsillar herniation below the foramen magnum was 8.7±3.8 (mm). Of the patients, 15 (42.85%) had syringomyelia. The degree of tonsillar ectopia was statistically significantly lower in patients with syringomyelia (p<0.05). The BBS scores were near identical among the patients with or without syringomyelia, although the FI values were lower in the patients with syringomyelia. Comparing cerebellar ectopia ≤9 mm versus >10 mm, the FI values were slightly higher in the patients with ectopia >10 mm, although there was no statistically significant difference in the FI or BBS values. Conclusion:Our study results suggest that CM-I can decrease the body balance stability and, thus, increase the fall risk. Evaluation of balance in patients with CM using TIBS static posturography is a simple and effective technique.

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The effect of hemodialysis on balance measurements and risk of fall

Cited by 32 publications

References 33 publications

Geriatric Assessment in Elderly Patients with End-Stage Kidney Disease

Geriatric Assessment in Elderly Patients with End-Stage Kidney Disease

Is there a relationship between plantar foot sensation and static balance, physical performance, fear of falling, and quality of life in hemodialysis patients?

Posturographic examination of body balance in patients with Chiari type I malformation and correlation with the presence of syringomyelia and degree of cerebellar ectopia

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