Rising from a chair A simple screening test for physical function in predialysis patients

Abstract

Objectives. Patients with chronic end-stage renal diseases have decreased physical fitness. This physical deconditioning is relative but the consequences in daily life are related to functional thresholds. The main purpose of this study was to gather information about physical performance, physical fitness and activity in predialysis patients. A second aim was to investigate the possibility of identifying patients at risk of physical deconditioning using clinical tests. Material and methods. Fifty-five predialysis patients with a glomerular filtration rate (GFR) of ≤20 ml/min/1.73 m² were investigated. They filled out questionnaires about their physical activity. Muscle performance was measured by using an electronic force transducer for grip strength and knee extension. Clinical tests, such as ‘Timed up and go’, walking, standing heel-rise and ‘Climbing up a 45-cm high step’, were performed. Results. There were no associations between GFR and the assessments of the above-mentioned tests. However, odds ratios calculated for ‘Rising from a 45-cm chair without using the arms’ and GFR and diabetes showed that, for every 1 ml/min/1.73 m² drop in GFR, the odds were 1.5 times higher that the patient would not be able to rise from a chair and, when the diagnosis was diabetes, the odds ranged from 1.7 to 21 times higher. Conclusions. Patients, especially diabetics, with chronic renal failure with a GFR of ≤20 ml/min/1.73 m² have decreased physical fitness. ‘Rising from a 45-cm chair without using the arms’ is an uncomplicated test to use in the clinical setting for identifying patients who need help with muscle training and functional exercise in order to improve their everyday functioning.

• Chronic renal failure
• diabetic nephropathy
• physical fitness
• muscle strength