Rising from a chair: a simple screening test for physical function in predialysis patients

Area of Science:

• Nephrology
• Geriatrics
• Physical Therapy

Background:

• Chronic end-stage renal disease is associated with decreased physical fitness and functional limitations.
• Physical deconditioning in predialysis patients impacts daily life activities.
• Identifying patients at risk of deconditioning is crucial for intervention.

Purpose of the Study:

• To assess physical performance, fitness, and activity levels in predialysis patients.
• To identify clinical tests capable of detecting patients at risk of physical deconditioning.

Main Methods:

• Fifty-five predialysis patients (GFR ≤20 ml/min/1.73 m²) completed physical activity questionnaires.
• Muscle strength was measured using grip strength and knee extension tests.
• Clinical functional tests included 'Timed up and go', walking, heel-rise, and a 45-cm chair step test.

Main Results:

• No significant association was found between GFR and most physical performance tests.
• Lower GFR and diabetes were associated with an increased inability to rise from a chair without arm support.
• Each 1 ml/min/1.73 m² decrease in GFR increased the odds of difficulty rising from a chair by 1.5 times.

Conclusions:

• Predialysis patients, particularly those with diabetes, exhibit reduced physical fitness.
• The 'Rising from a 45-cm chair without using the arms' test is a simple clinical tool to identify patients needing assistance.
• This test can guide interventions like muscle training and functional exercises to enhance daily functioning.