Sawant Anuradha, Overend Tom
London Health Sciences Center, London, ON N6G 5A5, Canada.
Department of Physiotherapy, Western University, London, ON N6G 1H1, Canada.
Healthcare (Basel). 2017 Dec 5;5(4):92. doi: 10.3390/healthcare5040092.
People with end-stage kidney disease (ESKD) on hemodialysis (HD) commonly have functional impairments. The purpose of this systematic review was to evaluate the effect of HD on spatio-temporal characteristics of gait, and effect of exercise on these parameters. Electronic databases were searched to identify relevant citations. Extracted data was computed using a random effects model for means (Hedges' and 95% confidence interval (CI). 27 studies met inclusion criteria. Mean values: gait speed (GS)-1.0 m/s (CI: 0.9-1.1 m/s; 16 studies), fast walking speed (FWS)-1.5 m/s (CI: 1.3-1.6 m/s; 7 studies), timed get-up & go test (TUG) -6.8 s (CI: 6.1-7.5 s; 2 studies), walk tests (WT) 193.0 s (CI: 116.0-270.0; 5 studies), 6 min-walk-test (6MWT)-386.6 m (CI: 243.2-530.0 m; 11 studies). 4 studies compared participants on HD with normal controls and 10 studies evaluated the effect of nutrition/exercise. Compared to age-matched populations, people with ESKD/HD had significantly slower GS and reduced walk distances; with intervention, the change in the distance walked was significant. Further research is required to evaluate the effect of HD on gait parameters, and the type of exercise/nutrition that will lead to meaningful changes.
接受血液透析（HD）的终末期肾病（ESKD）患者通常存在功能障碍。本系统评价的目的是评估血液透析对步态时空特征的影响，以及运动对这些参数的影响。通过检索电子数据库来识别相关文献。使用随机效应模型计算提取数据的均值（Hedges'值和95%置信区间（CI））。27项研究符合纳入标准。均值如下：步速（GS）-1.0米/秒（CI：0.9-1.1米/秒；16项研究），快走速度（FWS）-1.5米/秒（CI：1.3-1.6米/秒；7项研究），定时起立行走测试（TUG）-6.8秒（CI：6.1-7.5秒；2项研究），步行测试（WT）193.0秒（CI：116.0-270.0；5项研究），6分钟步行测试（6MWT）-386.6米（CI：243.2-530.0米；11项研究）。4项研究比较了接受血液透析的参与者与正常对照组，10项研究评估了营养/运动的效果。与年龄匹配的人群相比，ESKD/HD患者的步速明显较慢，步行距离缩短；经过干预后，步行距离的变化具有显著性。需要进一步研究来评估血液透析对步态参数的影响，以及能导致有意义变化的运动/营养类型。
