title: Implicit postural control strategies in older hemodialysis patients: an objective hallmark feature for clinical balance assessment.
abstract: Elderly patients with end stage renal diseases (ESRD) undergoing hemodialyis (HD) present poorer physical function and higher accident falls than healthy elderly population. Therefore, the aim of this study was to examine the HD-related changes in postural sway in ESRD patients, as an objective hallmark of their functional abilities. We hypothesized that the ESRD symptoms (i.e. uremic syndrome) and the HD therapy affected the postural control, evidenced by higher bounding limits of center-of-pressure (COP) velocity dynamics. Fifty-five participants, including 28 HD patients and 27 age, body mass index and gender-matched healthy participants HS (70.42 ± 13.69 years; 23.46 ± 4.67 kg/m(2); 35.7% women vs. 73.62 ± 6.59 years; 25.09 ± 3.54 kg/m(2); 37% women), were asked to maintain quiet stance on force platform, with eyes open and eyes closed. COP parameters were mean and standard deviation (SD) of position, velocity and average absolute maximal velocity (AAMV) in antero-posterior and medio-lateral directions. The results revealed a significant main effect of group on velocity-based variables, highlighting that mean velocity, SD velocity and AAMV (p<0.01) were higher for HD as compared to HS. These findings identified the bounding limits of COP velocity as an objective hallmark feature of HD-related changes in postural sway. The clinical assessment of this active control of COP velocity dynamics could be useful to examine the effects of targeted intradialytic exercise programs on functional performances and for early detection of increased fall risk in HD patients.
authors.affiliation: University of Nantes, Laboratory "Motricité, Interactions, Performance" (UPRES EA 4334), F-44000 Nantes, France.
authors.forename: Justine
authors.initials: J
authors.lastname: Magnard
authors.affiliation: Dialysis Unit, ECHO Nantes Dialysis Association, France.
authors.forename: Dan
authors.initials: D
authors.lastname: Hristea
authors.affiliation: Dialysis Unit, ECHO Nantes Dialysis Association, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Lefrancois
authors.affiliation: Dialysis Unit, ECHO Nantes Dialysis Association, France.
authors.forename: Angelo
authors.initials: A
authors.lastname: Testa
authors.affiliation: Dialysis Unit, ECHO Nantes Dialysis Association, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Paris
authors.affiliation: University of Nantes, Laboratory "Motricité, Interactions, Performance" (UPRES EA 4334), F-44000 Nantes, France. Electronic address: thibault.deschamps@univ-nantes.fr.
authors.forename: Thibault
authors.initials: T
authors.lastname: Deschamps
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000886:Anthropometry; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004856:Postural Balance / Q000502:physiology*; D011312:Pressure; D006435:Renal Dialysis
keywords: Hemodialysis patients; Posture; Velocity control hypothesis