Hand function in patients on maintenance hemodialysis.
The purpose of this study was to assess characteristics of hand function in 30 subjects on maintenance hemodialysis (MHD) with a forearm vascular access. Hand function was evaluated by measuring subjects' grip and pinch strength, range of motion, edema, and sensation and with the Grip Function Test and self-assessment scale. A difference in all hand function test results was found in the extremity with the vascular access compared with the contralateral extremity. Comparison of short-term subjects (on MHD less than two years) with long-term subjects (on MHD greater than two years) revealed significantly lower handgrip strength (p less than .05) and pinch strength (p less than .05) and significantly higher hand volume (edema) (p less than .05) in the long-term group than in the short-term group. We suggest that both the chronicity of renal failure and the presence of a vascular access may contribute to deterioration of hand function. The presence of hand deterioration in patients on MHD identifies a new patient population and a need for early baseline measurement and periodic assessment by physical therapists or hand therapists as renal rehabilitation team members.
Branz
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NR
Department of Physical Therapy, School of Allied Health Professions, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0001.
Newton
R A
RA
D000328:Adult; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D004292:Dominance, Cerebral; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors; D014953:Wrist / Q000503:physiopathology