The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review
<p>Flow Chart of Study Selection for the systematic review.</p> "> Figure 2
<p>Results of effect of exercise on gait speed in studies using pre-post design. 6MWT: six min walk test; HD: hemodialysis; m/s: meters per second.</p> "> Figure 3
<p>Results of effect of exercise on 6MWT in studies using pre-post design. 6MWT: six minute walk test; HD: hemodialysis.</p> "> Figure 4
<p>Results of effect of exercise on gait speed in studies using controlled study design.</p> "> Figure 5
<p>Results of effect of exercise on TUG in studies using controlled study design. TUG: timed get-up and go test.</p> "> Figure 6
<p>Effect of exercises on six minute walk test. 6MWT: six minute walk test; HD: hemodialysis; m: meter.</p> ">
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Outcome Measures
2.5. Data Collection and Analysis
2.6. Statistical Analyses
3. Results
3.1. Effect of Hemodialysis on Spatiotemoporal Gait Parameters
3.2. Comparison with Normal Controls
3.3. Effect of Exercise or Nutritional Intervention on Spatiotemoporal Gait Parameters
4. Discussion
Limitations
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Study Name | Subgroup within Study | Outcome | Mean (Standard Deviation) | Sample Size (N) | Age of Participants in Years | Dialysis Vintage in Months (Mean (Standard Deviation) or Range) |
---|---|---|---|---|---|---|
Abe 2016 [22] | Participants on HD | Fast walking (m/s) | 1.52 (0.34) | 122 | 68.0 (9) | 103.2 (103.2) |
Blake 2004 [23] | Participants on HD | Normal walking (m/s) | 1.31 (0.12) | 12 | 42 (8.5) | Median 11.5 (4.25) |
Fast walking (m/s) | 1.74 (0.18) | 12 | ||||
Bulckaen 2011 [24] | Participants on HD (AWG group) | Treadmill walk Test | 242 (208) | 9 | 60 (9) | 25.8 |
6MWT (m) | 436 (139) | 9 | ||||
Steps per day | 2908 (1622) | 9 | ||||
Participants on HD (SWG group) | Treadmill walk Test | 248 (197) | 18 | 51 (12) | ||
6MWT (m) | 439 (124) | 18 | ||||
Steps per day | 5000 (2904) | 18 | ||||
Chang 2016 [25] | Participants on HD (intervention group) | 6MWT (m) | 389.9 (36.1) | 21 | 54.2 15.2) | 2.0 (1.3) |
Gait speed (m/s) | 98.9 (23.9) | 21 | ||||
Participants on HD (control group) | 6MWT (m) | 387.2 (63.9) | 25 | 54.6 12.7) | 1.6 (0.9) | |
Gait speed (m/s) | 102.2 (17.6) | 25 | ||||
Cheema 2007 [26] | Participants on HD (PRT group) | 6MWT | 496.6 (133.2) | 24 | 60.0(15.3) | 39.6 Mean Range (3.6–200.4) |
Participants on HD (Control group) | 6MWT | 406.4 (122.8) | 25 | |||
Cheema 2010 [27] | Participants on HD | 6MWT (m) | 450.6 (134.7) | 49 | 62.5 (14.2) | 26.4 (16.7) |
Normal walking (m/s) | 1.0 (0.28) | 49 | ||||
Golebiowski 2012 [28] | Participants on HD | 6MWT (m) | 0.99(1.3) | 29 | 64.2 (13.1) | 4–192 Range |
Headley 2002 [29] | Participants on HD | 6MWT (m) | 522.1 (46.2) | 10 | 42.8 (4.4) | 41.6 (19) |
Fast walking (m/s) | 1.83 (0.13) | 10 | ||||
Normal walking (m/s) | 1.21 (0.61) | 10 | ||||
Henrique 2010 [30] | Participants on HD | 6MWT (m) | 509 (91.9) | 14 | 47.6 (12.7) | 93.7 (43.9) |
Hotta 2015 [31] | Participants on HD with sarcopenia | Gait speed (m/s) | 1.4 (0.1) | 14 | 70.5 (2.2 | 53.3 (5.5) |
Participants on HD without sarcopenia | Gait speed (m/s) | 2.0 (0.1) | 19 | 65.5 (2.4) | 50.1 (8.8) | |
Jeong 2015 [32] | Patients with LVDD | Gait speed (m/s) | 0.7 (0.2) | 40 | 54.5 (11.1) | 42.9 (37.9) |
ISWT (seconds) | 188 (102.1) | 40 | ||||
Patients without LVDD | Gait speed (m/s) | 0.9 (0.3) | 42 | |||
ISWT (seconds) | 261.4 (117.7) | 42 | ||||
Jin 2017 [33] | Participants on HD with T2DM | Gait speed (m/s) | 0.87 (0.21) | 35 | 63.89 (9.57) | 54.26 (49.61) |
Participants on HD without T2DM | Gait speed (m/s) | 1.0 (0.23) | 25 | 56.4 (14.67) | 81.64 (70.12) | |
Johansen 2001 [34] | Participants on HD | Gait speed (m/s) | 1.13 (0.34) | 46 | 52 (17) | 27.6 (27.5) |
Johansen 2001 [35] | Participants on HD | Gait Speed (m/s) | 1.15 (0.34) | 39 | 52 (16) | 28.8 (28.8) |
Johansen 2003 [5] | Participants on HD | Gait speed (m/s) | 1.0 (0.33) | 38 | 55 (15) | 34.8 (32.7) |
Johansen 2015 [36] | Participants on HD | Gait speed (m/s) | 0.93 (0.68) | 68 | 69 (14) | 44.4 Mean Range (19.2–75.6) |
Johansen 2014 [37] | Participants on HD (Non-frail group) | Normal walking speed m/s | 1.0 (0.2) | 321 | 53.8 (14.4) | 44.4 Mean Range (19.2–75.6) |
Koh 2010 [38] | HD participants on home exercises | 6MWT (m) | 444 (127) | 14 | 52.1 (13.6) | 37.0 (31.1) |
TUG in seconds | 5.7 (2.0) | 14 | ||||
HD participants on intradialytic exercise | 6MWT (m) | 463 (127) | 14 | 52.3 (10.9) | 32.1 (26.7) | |
TUG in seconds | 5.8 (1.5) | 14 | ||||
HD participants receiving usual care | 6MWT (m) | 431 (160) | 16 | 51.3 (14.4) | 25.8 (22.2) | |
TUG in seconds | 6.3 (2.5) | 16 | ||||
Kutsuna 2010 [39] | Participants on HD | Fast walking (m/s) | 1.52 (0.42) | 153 | 64 (11) | 93.6 (80.4) |
Normal walking (m/s) | 1.13 (0.28) | 153 | ||||
Lane 2013 [40] | Participants on HD | SWT (in seconds) | 251 (120) | 42 | 44(5) | 51 (42) |
Malagoni 2008 [41] | Participants on HD (control group) | 6MWT (m) | 275 (69) | 7 | 66 (14) | 90 (73) |
Participants on HD (experimental group) | 6MWT (m) | 308 (105) | 13 | 62 (10) | 78 (50) | |
Manfredini 2007 [42] | Participants on HD | 6MWT (m) | 283 (122) | 16 | 65.1 (11.4) | 82 (77) |
Max. treadmill speed m/s | 0.92 (0.31) | 16 | ||||
Mercer 2002 [43] | Participants on HD + PD (experimental group) | 50 m walk test | 146 (38.1) | 7 | 63..0 (14.5) | 30 (18) |
Participants on HD + PD (control group) | 50 m walk test | 139.1 (21.3) | 9 | 59 (12.3) | 45.6 (33.6) | |
Painter 2000 [44] | Participants on HD | 6MWT (m) | 347.10 (127.10) | 44 | 55.9 (15.15) | 33.7 (35.6) |
Fast walking (m/s) | 1.30 (0.40) | 131 | ||||
Normal walking (m/s) | 0.9 (0.26) | 131 | ||||
Shin 2013 [45] | Participants on HD | Normal walking (m/s) | 1.0 (0.247) | 14 | 50.0 (11.8) | 51.6 (35.5) |
Cadence (steps/min) | 100.1 (12.6) | 14 | ||||
Step length (cm) | 59.7 (12.7) | 14 | ||||
Step width (cm) | 62.05 (11.7) | 14 | ||||
Double support (%GC) | 34.5 (6.8) | 14 | ||||
Swing phase (%GC) | 32.9 (3.5) | 14 | ||||
Tao 2015 [46] | Participants on HD (experimental group) | Fast walking (m/s) | 1.17 (0.27) | 56 | 53.02 (11.62) | 83.46 (63.7) |
Normal walking (m/s) | 1.21(0.25) | 57 | ||||
Participants on HD (Control group) | Fast walking (m/s) | 1.6 (0.4) | 56 | 56.68 (9.67) | 84.7 (70.55) | |
Normal walking (m/s) | 1.17 (0.27) | 56 | ||||
Tomayko 2015 [47] | Participants on HD receiving Nutrition (Whey) group | Gait speed (m/s) | 0.84 (0.27) | 11 | 57 (4.8) | Not reported |
Shuttle walk test | 216 (36) | |||||
TUG in seconds | 7.3 (1.0) | |||||
Participants on HD (Control group) | Gait speed (m/s) | 0.86 (0.29) | 15 | 53.3 (2.4) | ||
Shuttle walk test | 222 (34) | |||||
TUG in seconds | 7.7 (0.9) | |||||
Participants on HD receiving Nutrition (Soy) group | Shuttle walk Test | 268 (35) | 12 | 52.5 (4.3) | ||
TUG in seconds | 7.6 (1.1) | |||||
Gait speed (m/s) | 0.86 (0.23) |
Study Name | Subgroup within Study | Outcome Measure | Mean | 95% Confidence Interval | |
---|---|---|---|---|---|
Lower Limit | Upper Limit | ||||
Blake 2004 [23] | Participants on HD | Normal walking (m/s) | 1.31 | 1.24 | 1.38 |
Chang 2016 [25] | Participants on HD (intervention group) | Gait Speed (m/s) | 1.02 | 0.95 | 1.09 |
Participants on HD (control group) | Gait Speed (m/s) | 0.99 | 0.89 | 1.09 | |
Cheema 2010 [27] | Participants on HD | Normal walking (m/s) | 1.00 | 0.92 | 1.08 |
Headley 2002 [29] | Participants on HD | Normal walking (m/s) | 1.21 | 0.83 | 1.59 |
Jeong 2015 [32] | Patients with LVDD | Gait Speed (m/s) | 0.70 | 0.64 | 0.76 |
Patients without LVDD | Gait Speed (m/s) | 0.90 | 0.81 | 0.99 | |
Jin 2017 [33] | Participants on HD with T2DM | Gait Speed (m/s) | 0.87 | 0.80 | 0.94 |
Participants on HD without T2DM | Gait Speed (m/s) | 1.00 | 0.91 | 1.09 | |
Johansen 2001 [34] | Participants on HD | Gait Speed (m/s) | 1.13 | 1.03 | 1.23 |
Johansen 2001 [35] | Participants on HD | Gait Speed (m/s) | 1.15 | 1.04 | 1.26 |
Johansen 2003 [5] | Participants on HD | Gait Speed (m/s) | 1.00 | 0.90 | 1.11 |
Johansen 2015 [36] | Participants on HD | Gait Speed (m/s) | 0.93 | 0.77 | 1.09 |
Johansen 2014 [37] | Participants on HD (Non-frail group) | Normal walking (m/s) | 1.00 | 0.98 | 1.02 |
Kutsuna 2010 [39] | Participants on HD | Normal walking (m/s) | 1.13 | 1.09 | 1.17 |
Painter 2000 [44] | Participants on HD | Normal walking (m/s) | 0.90 | 0.86 | 0.94 |
Shin 2013 [45] | Participants on HD | Normal walking (m/s) | 1.00 | 0.87 | 1.13 |
Tao 2015 [46] | Participants on HD (Control group) | Normal walking (m/s) | 1.17 | 1.10 | 1.24 |
Participants on HD (experimental group) | Normal walking (m/s) | 1.21 | 1.15 | 1.27 | |
Tomayko 2015 [47] | Participants on HD receiving Nutrition (Whey) group | Gait Speed (m/s) | 0.84 | 0.68 | 1.00 |
Participants on HD (Control group) | Gait Speed (m/s) | 0.86 | 0.71 | 1.01 | |
Participants on HD receiving Nutrition (Soy) group | Gait Speed (m/s) | 0.86 | 0.73 | 0.99 | |
1.01 | 0.95 | 1.07 |
Study Name | Subgroup within Study | Outcome | Statistics for Each Study | 95% Confidence Interval | |
---|---|---|---|---|---|
Mean | Lower Limit | Upper Limit | |||
Abe 2016 [22] | Participants on HD | Fast walking (m/s) | 1.52 | 1.46 | 1.58 |
Blake 2004 [23] | Participants on HD | Fast walking (m/s) | 1.74 | 1.64 | 1.84 |
Headley 2002 [29] | Participants on HD (HEP) | Fast walking (m/s) | 1.83 | 1.75 | 1.91 |
Kutsuna 2010 [39] | Participants on HD | Fast walking (m/s) | 1.52 | 1.45 | 1.59 |
Manfredini 2007 [42] | Participants on HD | Max. Treadmill Speed (m/s) | 0.92 | 0.77 | 1.07 |
Painter 2000 [44] | Participants on HD | Fast walking (m/s) | 1.30 | 1.23 | 1.37 |
Tao 2015 [46] | Participants on HD (control group) | Fast walking (m/s) | 1.60 | 1.50 | 1.70 |
Participants on HD (experimental group) | Fast walking (m/s) | 1.17 | 1.10 | 1.24 | |
Random effects | 1.45 | 1.28 | 1.62 |
Study Name | Subgroup within Study | Statistics for Each Study | 95% Confidence Limit | |
---|---|---|---|---|
Mean (Seconds) | Lower Limit | Upper Limit | ||
Koh 2010 [38] | Participants on HD (home exercises | 5.70 | 4.65 | 6.75 |
Participants on HD (intradialytic exercises) | 5.80 | 5.01 | 6.59 | |
Participants on HD (usual care) | 6.30 | 5.08 | 7.52 | |
Tomayko 2015 [47] | Participants on HD (nutrition (Whey) group) | 7.30 | 6.71 | 7.89 |
Participants on HD (control group) | 7.70 | 7.24 | 8.16 | |
Participants on HD (nutrition (Soy) group) | 7.60 | 6.98 | 8.22 | |
Random effects | 6.82 | 6.13 | 7.52 |
Study name | Subgroup within Study | Statistics for Each Study | 95% Confidence Limits | |
---|---|---|---|---|
Mean | Lower Limit | Upper Limit | ||
Bulckaen 2011 [24] | Participants on HD AWG | 436.00 | 345.19 | 526.81 |
Participants on HD SWG | 439.00 | 381.72 | 496.28 | |
Chang 2016 [25] | Participants on HD (control group) | 387.20 | 362.15 | 412.25 |
Participants on HD (intervention group) | 389.90 | 374.46 | 405.34 | |
Cheema 2007 [26] | Participants on HD (control group) | 406.42 | 358.25 | 454.59 |
Participants on HD (experimental group) | 496.61 | 443.29 | 549.93 | |
Cheema 2010 [27] | Participants on HD (experimental group) | 450.60 | 412.88 | 488.32 |
Headley 2002 [29] | Participants on HD | 522.10 | 493.47 | 550.73 |
Henrique 2010 [30] | Participants on HD | 509.00 | 460.86 | 557.14 |
Koh 2010 [38] | Participants on HD (home exercises) | 444.00 | 377.47 | 510.53 |
Participants on HD (intradialytic exercises) | 463.00 | 396.47 | 529.53 | |
Participants on HD (usual care) | 431.00 | 352.60 | 509.40 | |
Malagoni 2008 [41] | Participants on HD (control group) | 275.00 | 223.89 | 326.11 |
Participants on HD (experimental group) | 308.00 | 250.92 | 365.08 | |
Manfredini 2007 [42] | Participants on HD | 283.00 | 223.22 | 342.78 |
Painter 2000 [44] | Participants on HD | 347.10 | 309.55 | 384.65 |
Random effects | 411.56 | 377.02 | 446.10 |
Study Name | Subgroup within Study | Outcome | Statistics for Each Study | 95% Confidence Interval | |
---|---|---|---|---|---|
Mean Time in Seconds | Lower Limit | Upper Limit | |||
Bulckaen 2011 [24] | Participants on HD (AWG) | Treadmill walk test | 242.00 | 106.11 | 377.89 |
Participants on HD (SWG) | Treadmill walk test | 248.00 | 156.99 | 339.01 | |
Jeong 2015 [32] | Patients with LVDD | ISWT (seconds) | 188.00 | 156.36 | 219.64 |
Patients without LVDD | ISWT (seconds) | 261.40 | 225.80 | 297.00 | |
Lane 2013 [40] | Participants on HD | SWT (in seconds) | 25.10 | 21.47 | 28.73 |
Mercer 2002 [43] | Participants on HD + PD (control group) | 50 m walk test | 139.10 | 125.18 | 153.02 |
Participants on HD + PD (experimental group) | 50 m walk test | 146.00 | 117.78 | 174.22 | |
Tomayko 2015 [47] | Participants on HD Nutrition (Whey) group | Shuttle walk test | 216.00 | 194.73 | 237.27 |
Participants on HD control group | Shuttle walk test | 222.00 | 204.79 | 239.21 | |
Participants on HD Nutrition (Soy) group | Shuttle walk test | 268.00 | 248.20 | 287.80 | |
Random | 193.55 | 116.36 | 270.73 |
Study Name | Outcome | Statistics for Each Study | 95% Confidence Limit | p-Value | |
---|---|---|---|---|---|
Hedges’s g | Lower Limit | Upper Limit | |||
Blake 2004 [23] | Normal walking (m/s) | 1.58 | 0.69 | 2.47 | 0.00 |
Johansen 2003 [5] | Gait Speed (m/s) | 1.45 | 0.85 | 2.06 | 0.00 |
Johansen 2001 [34] | Gait Speed (m/s) | 0.62 | 0.02 | 1.22 | 0.04 |
Shin 2013 [45] | Normal walking (m/s) | 1.60 | 0.77 | 2.44 | 0.00 |
Random effects | 1.26 | 0.76 | 1.76 | 0.00 |
Study Name | Outcome | Hedges’s g | Std Err |
---|---|---|---|
Shin 2013 [45] | Cadence (steps/minute) | 1.03 | 0.39 |
Double Support (%GC) | −1.03 | 0.39 | |
Step length (cm) | 1.21 | 0.40 | |
Step width (cm) | 1.18 | 0.40 | |
Swing Phase (%GC) | 0.98 | 0.39 |
© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Sawant, A.; Overend, T. The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review. Healthcare 2017, 5, 92. https://doi.org/10.3390/healthcare5040092
Sawant A, Overend T. The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review. Healthcare. 2017; 5(4):92. https://doi.org/10.3390/healthcare5040092
Chicago/Turabian StyleSawant, Anuradha, and Tom Overend. 2017. "The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review" Healthcare 5, no. 4: 92. https://doi.org/10.3390/healthcare5040092