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Published on: December 11, 2013
Postural control in hemodialysis patients
Sunghoon Shin1, Hae Ryong Chung2, Peter J Fitschen3
1Department of Biomedical Engineering, Kyung Hee Univeristy, Yongin, Republic of Korea.
Insights
Patients undergoing hemodialysis (dialysis) exhibit poorer standing balance and a greater dual task cost (DTC) when performing cognitive tasks, indicating increased fall risk.
Area of Science:
- Nephrology
- Gerontology
- Biomedical Engineering
Background:
- Patients undergoing hemodialysis (HD) often experience comorbidities that may affect neurological function.
- Postural control is crucial for daily activities and fall prevention.
- Cognitive function can impact motor performance, particularly in vulnerable populations.
Purpose of the Study:
- To compare standing postural control and dual task cost (DTC) between hemodialysis patients and healthy controls.
- To investigate the effect of cognitive load on postural sway in individuals undergoing HD.
- To assess the potential fall risk associated with impaired postural control in HD patients.
Main Methods:
- 19 hemodialysis patients and 19 age, gender, and BMI-matched controls participated.
- Participants performed quiet standing balance tasks and cognitive-motor dual tasks.
- Postural control was measured using center of pressure (COP) trajectory parameters.
Main Results:
- Hemodialysis patients demonstrated significantly greater postural sway compared to controls.
- Hemodialysis patients exhibited a significantly higher dual task cost (DTC) than controls.
- Cognitive task performance exacerbated postural instability in HD patients.
Conclusions:
- Hemodialysis patients have impaired postural control, which worsens with cognitive demand.
- This heightened dual task cost suggests an increased risk of falls in HD patients.
- Further research is needed to identify causes and explore interventions like exercise to reduce DTC.
Abstract:
The current investigation examined whether patients undergoing hemodialysis (HD) have reduced standing postural control performance during simultaneous cognitive task performance (i.e. dual task cost (DTC)) compared to age-gender matched controls. 19 persons undergoing HD and 19 age, gender, and body mass index (BMI) matched controls participated in the investigation. All participants performed 2 trials of quiet standing balance and 2 postural trials in which they performed a cognitive task. Postural control was indexed with various measures of the center of pressure (COP) trajectory. The change in postural control with a cognitive task (e.g. dual task cost DTC) was quantified as a change in the center of COP parameters of postural control from quiet standing to the cognitive condition. The primary observations were that (1) HD patients had significantly greater postural sway than age, gender, BMI matched controls (p's < 0.05); (2) HD patients had a greater DTC than the controls during quiet standing (p's < 0.05). The observations highlight that HD participants have poor postural control that is further exacerbated by a simultaneous performance of a cognitive task. It is possible that this impaired postural control places HD participants at elevated fall risk. Further study is necessary to determine contributing factors to an increased DTC in this population and whether targeted interventions such as exercise can reduce DTC.
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