Chronic Disease Innovation Centre, Seven Oaks General Hospital Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Curr Opin Nephrol Hypertens. 2020 May;29(3):346-350. doi: 10.1097/MNH.0000000000000594.
People with chronic kidney disease have a high prevalence of poor physical function, which in turn is associated with poor health-related quality of life, and an increased risk of adverse events, including hospitalizations and all-cause mortality. Implementing early interventions may prove to be effective for preventing decline in physical function; however, it is imperative that clinicians screen patients to identify those at the highest risk of decline. In this review, we present subjective and objective screening tools that can easily and cost-effectively be implemented into routine nephrology practice to assess physical function.
Physical function can be assessed using commonly used physical performance tests that include objective measures, such as tests measuring gait speed, balance, chair-stand ability, and handgrip strength, as well as tests that include subjective self-reported measures.
The validated tools summarized in this review offer clinicians the ability to identify people at risk of poor physical function, in turn affording the opportunity to implement interventions for optimum management of risk of physical decline, preventing adverse health outcomes, and encouraging independence.
慢性肾脏病患者身体机能较差的发生率较高,而较差的身体机能又与较差的健康相关生活质量和更高的不良事件风险(包括住院和全因死亡率)相关。早期干预可能对预防身体机能下降有效;然而,临床医生必须对患者进行筛查,以确定那些身体机能下降风险最高的患者。在本次综述中,我们提出了一些主观和客观的筛选工具,这些工具可以方便且经济有效地纳入常规肾脏病学实践中,以评估身体机能。
身体机能可以使用常用的身体表现测试进行评估,这些测试包括客观的测量,如测量步态速度、平衡、坐站能力和握力的测试,以及包括主观自我报告测量的测试。
本综述中总结的经过验证的工具使临床医生能够识别出身体机能较差的人群,从而有机会实施干预措施来优化身体机能下降风险的管理,预防不良健康结果,并鼓励独立。