Abstract: FR-PO862

Does Hemodialysis Impact Motor Performance beyond Diabetes and Peripheral Neuropathy? Objective Assessment of Gait and Balance Using Wearable Technology in a Hemodialysis Clinic

Session Information

Category: Dialysis

  • 607 Dialysis: Epidemiology, Outcomes, Clinical Trials - Non-Cardiovascular

Authors

  • Siddiqi, Noreen, Baylor College of Medicine, Houston, Texas, United States
  • Zhou, He, Baylor College of Medicine, Houston, Texas, United States
  • Al-Ali, Fadwa S., Hamad Medical Corporation , Doha, Qatar
  • Hamad, Abdullah, Hamad Medical Corporation , Doha, Qatar
  • Ibrahim, Rania Abdelaziz, Hamad Medical Corporation , Doha, Qatar
  • Talal, Talal, Hamad Medical Corporation , Doha, Qatar
  • Sardon melo, Sergio Nicolas, Hamad Medical Corporation , Doha, Qatar
  • Najafi, Bijan, Baylor College of Medicine, Houston, Texas, United States
Background

Poor motor-performance is a serious problem for older adults undergoing hemodialysis (HD) treatment. HD process often leaves these patients too fatigued to engage in any physical activity or daily exercise; further deteriorating their gait and balance. In particular, little is known about how HD impacts gait and balance mainly due to difficulty of bringing these highly vulnerable population to a gait lab. In this study, we used wearable sensors to objectively examine the impact of HD on gait and balance.

Methods

33 eligible subjects (age=66+6years, body mass index=31+7kg/m2, male=58%) in 3 age-matched groups were recruited: 11 undergoing HD treatment, 11 with diabetes peripheral neuropathy (DPN) not requiring HD and 11 healthy controls (HC). Gait and balance performances were assessed using wearable sensors. Single task walking (ST), dual task waking (DT), and double stance balance under eyes open (EO) and eyes closed (EC) conditions were measured.

Results

The HD group had the worst gait performance compared to other groups, which reached statistical significant level after adjusting for demographic information. The highest effect size to discriminate between HD and DPN as well as between HD and HC, was ST stride velocity (d=4.825, p<0.001 and d=7.361, p<0.001). The HD group had the worst balance performance of all groups. Between-group differences of ankle sway and hip sway under both EO and EC conditions, reached statistical significance. The largest effect size to discriminate between the HD and DPN groups as well as between the HD and HC, occurred at EO hip sway (d=1.692, p<0.001) and EC hip sway (d=1.868, p<0.001).

Conclusion

To our knowledge this is the first study that utilize wearable technology to objectively characterize gait and balance in HD patients during clinic visit. Results demonstrated HD patients have significantly poorer gait and balance, even when compared to DPN patients. Poor balance and gait reduce the ability of HD patients to be active, which in turn may impact the outcomes and associated risk including poor lower extremities perfusion, foot problems, falls and early frailty.

Funding

  • Government Support - Non-U.S.