Modifiable Physical Factors Associated With Physical Functioning for Patients Receiving Dialysis: A Systematic Review

Area of Science:

• Nephrology
• Physical Therapy
• Rehabilitation Medicine

Background:

• Patients undergoing dialysis often experience diminished physical function.
• Reduced physical function is linked to adverse clinical outcomes and lower quality of life in this population.

Purpose of the Study:

• To identify and examine modifiable physical factors associated with physical function in patients receiving dialysis.
• To provide insights for interventions aimed at improving physical function in dialysis patients.

Main Methods:

• A systematic literature search was conducted across major databases (MEDLINE, Embase, Ovid Emcare, Cochrane Library) in October 2018.
• Included studies focused on etiological factors in dialysis populations, reporting associations between modifiable physical factors and physical function.
• Eligible predictor variables were those amenable to exercise modification and classified as impairments in the International Classification of Functioning, Disability and Health.

Main Results:

• Out of 5384 titles, 23 studies met the inclusion criteria.
• Physical activity levels showed a moderately strong association with physical function.
• Muscle strength demonstrated a predominantly weak to moderate relationship with physical function, while sedentary behavior was also investigated.

Conclusions:

• Physical activity levels, sedentary behavior, and muscle strength are demonstrably related to physical function in dialysis patients.
• Further high-quality longitudinal research is recommended to validate these findings.
• Future studies should also increase focus on patients undergoing peritoneal dialysis.