Muscle strength impairments and gait performance deficits in kidney transplantation candidates

The purposes of this study of patients referred for renal transplant were to describe muscle strength impairments and deficits in gait performance and to establish the relationship between them. Twenty-six patients were tested. Muscle strength measurements included grip, elbow flexion, and shoulder abduction in the upper extremities, and ankle dorsiflexion, knee extension, hip abduction, and timed sit-to-stands in the lower extremities. Gait performance (level ground and stair) was quantified using ordinal scales and speed. Compared with healthy control subjects, patients demonstrated impairments in muscle strength and deficits in gait performance. Patients with diabetes demonstrated greater impairments and deficits than patients without diabetes. Patients with an active fistula demonstrated better grip strength in their upper extremity without the fistula. Gait performance was correlated significantly with lower extremity strength, with knee extension strength and weight providing the best prediction of gait speed (R2 = 0.478 to 0.617). The results of this study suggest that patients referred for renal transplantation possess both strength impairments and deficits in gait performance, the latter being related to the former. The clinician wishing to efficiently monitor strength impairments among patients referred for transplantation can obtain a reasonable indication of them from dynamometric grip and knee extension strength measurements.