scholarly journals Quantitative sonographic assessment of quadriceps muscle thickness for fall injury prediction in patients undergoing maintenance hemodialysis: an observational cohort study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Asuka Sai ◽  
Kentaro Tanaka ◽  
Yasushi Ohashi ◽  
Akifumi Kushiyama ◽  
Yoshihide Tanaka ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Thigh Circumference ◽  
Men And Women ◽  
Fall Injuries ◽  
Fall Injury ◽  
Observational Cohort

Abstract Background Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be a primary component of fall prevention. This study investigated whether quadriceps muscle thickness measured using ultrasonography can predict fall injury among dialysis patients. Methods Using an observational cohort study design, 180 ambulatory hemodialysis patients were recruited from 2015 to 2016 from four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient’s self-report during the one-year period. Results Among the 180 hemodialysis patients, 44 (24.4%) had fall injuries during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertiles, patients in the lowest tertile were more likely to have a higher incidence of fall injury than those in the higher two tertiles (0.52 vs. 0.19 and 0.17 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor of fall injury (hazard ratio [95% confidence interval], 2.33 [1.22–4.52], P < 0.05). Receiver operating characteristic curves were constructed to determine the optimal cutoffs of quadriceps muscle thickness, thigh circumference, and handgrip strength that best predicted fall injury (quadriceps muscle thickness, 3.37 cm and 3.54 cm in men and women; thigh circumference, 44.6 cm and 37.2 cm in men and women; and handgrip strength, 23.3 kg and 16.5 kg in men and women). Using these cutoff values, the areas under the curve were 0.662 (95% CI, 0.576–0.738), 0.625 (95% CI, 0.545–0.699), and 0.701 (95% CI, 0.617–0.774), for quadriceps muscle thickness, thigh circumference, and handgrip strength, respectively. Quadriceps muscle thickness was a more precise predictor of fall injury than thigh circumference and had similar diagnostic performance as handgrip strength tests in dialysis patients. Conclusions Quadriceps muscle thickness can be measured easily at the bedside using ultrasonography and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis.

scholarly journals Quantitative Sonographic Assessment of Quadriceps Muscle Thickness for Prospective Fall Injury in Patients Undergoing Maintenance Hemodialysis: an Observational Cohort Study

2020 ◽  
Author(s):  
Asuka Sai ◽  
Kentaro Tanaka ◽  
Yasushi Ohashi ◽  
Akifumi Kushiyama ◽  
Yoshihide Tanaka ◽  
...  
Keyword(s):  
Cohort Study ◽  
Handgrip Strength ◽  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Hemodialysis Patients ◽  
Observational Cohort Study ◽  
Maintenance Hemodialysis ◽  
Thigh Circumference ◽  
Fall Injury ◽  
Observational Cohort

Abstract Introduction: Accidental fall risk is high in patients undergoing maintenance hemodialysis. Falls are associated with fatal injury, comorbidities, and mortality. Risk assessment should be conducted as a primary intervention to prevent falls. This study investigated whether quadriceps muscle thickness measured using ultrasonography can prospectively predict fall injury among dialysis patients.Methods: Using an observational cohort study design, 180 ambulatory hemodialysis patients during the period 2015–2016 were recruited in the four dialysis clinics. The sum of the maximum quadriceps muscle thickness on both sides and the average of the maximum thigh circumference and handgrip strength after hemodialysis were calculated. Patients were stratified according to tertiles of quadriceps muscle thickness. Fall injury was surveyed according to the patient’s self-report for the one-year period.Results: Among the 180 hemodialysis patients, 42 (23.3%) had fall injury during the 12-month follow-up period. When the quadriceps muscle thickness levels were stratified into sex-specific tertile, patients in the lowest tertile (men <3.66 cm and women <3.50 cm) were more likely to have higher incidence of fall injury compared with those in the higher two tertiles (0.56 vs. 0.18 and 0.15 fall injuries/person-year). After adjusting for covariates, lower quadriceps muscle thickness was found to be an independent predictor for fall injury (hazard ratio [95% confidence interval], 2.99 [1.46–6.32], P < 0.001). Conversely, no significant differences were found in the thigh circumference and handgrip strength between women with fall injury and those women without fall injury.Conclusions: Quadriceps muscle thickness using ultrasonography can be measured easily at the bedside and is a precise predictor of fall injury in patients undergoing maintenance hemodialysis.

scholarly journals Relationship between quadriceps thickness and 60-second sit-to-stand test in patients with chronic kidney disease

2021 ◽  
Author(s):  
Marthley J. C. Costa ◽  
Frederico C. B. Cavalcanti ◽  
Shirley Dias Bezerra ◽  
José Candido de Araújo Filho ◽  
Juliana Fernandes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Functional Performance ◽  
Handgrip Strength ◽  
Muscle Thickness ◽  
Quadriceps Muscle ◽  
Stand Test ◽  
Sit To Stand ◽  
The Relationship

Abstract Background: This study aimed to evaluate the relationship between quadriceps muscle thickness and functional performance on the 60s sit-to-stand test (60s-STS), the six-minute walk test (6MWT), and handgrip strength in non-dialytic stage 4 and 5 chronic kidney disease (CKD) patients. Methods: This was a cross-sectional study that evaluated 40 CKD patients aged between 30-70 years. Participants were submitted to an assessment that included quadriceps muscle thickness evaluated by a portable ultrasound. Functional performance tests included the 60s-STS, distance walked in the 6MWT, and handgrip strength. Also, body composition evaluated using electrical bioimpedance analysis and physical activity level through the short version of International Physical Activity were measured. Multiple linear regression was used to investigate the relationship between the quadriceps thickness and functional performance. Results: Quadriceps muscle thickness was correlated to 60s-STS (R2 = 43.6%; 95% CI = 0.022 - 0.665; β = 0.34; p = 0.037). Also, a moderate correlation between this muscle thickness and appendicular skeletal muscle (ALM) was found in CKD patients (r = 0.603, p <0.001). No relationship was found between quadriceps muscle thickness with the 6MWT and handgrip strength. Conclusion: Quadriceps muscle thickness is associated to 60s-STS, thus our results demonstrate the repercussions of the disease on the musculoskeletal system.

Associations between Handgrip Strength and Ultrasound-Measured Muscle Thickness of the Hand and Forearm in Young Men and Women

2015 ◽  
Vol 41 (8) ◽  
pp. 2125-2130 ◽  
Author(s):  
Takashi Abe ◽  
Brittany R. Counts ◽  
Brian E. Barnett ◽  
Scott J. Dankel ◽  
Kofan Lee ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Young Men ◽  
Muscle Thickness ◽  
Men And Women

Handgrip Strength as a Simple Indicator of Possible Malnutrition and Inflammation in Men and Women on Maintenance Hemodialysis

2011 ◽  
Vol 21 (3) ◽  
pp. 235-245 ◽  
Author(s):  
Luciana Ferreira Silva ◽  
Cácia Mendes Matos ◽  
Gildete Barreto Lopes ◽  
Maria Tereza Silveira Martins ◽  
Márcia Silva Martins ◽  
...  
Keyword(s):  
Handgrip Strength ◽  
Maintenance Hemodialysis ◽  
Men And Women ◽  
Simple Indicator

Serum Thiamine Values in End-Stage Renal Disease Patients under Maintenance Hemodialysis

2015 ◽  
Vol 85 (5-6) ◽  
pp. 348-355 ◽  
Author(s):  
Masamitsu Ubukata ◽  
Nobuyuki Amemiya ◽  
Kosaku Nitta ◽  
Takashi Takei
Keyword(s):  
Thiamine Deficiency ◽  
Risk Index ◽  
Nutritional Risk ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Significant Difference ◽  
Nutritional Risk Index ◽  
Serum Aspartate Aminotransferase ◽  
Stage Renal Disease ◽  
End Stage

Abstract. Objective: Hemodialysis patients are prone to malnutrition because of diet or many uremic complications. The objective of this study is to determine whether thiamine deficiency is associated with regular dialysis patients. Methods: To determine whether thiamine deficiency is associated with regular dialysis patients, we measured thiamine in 100 patients undergoing consecutive dialysis. Results: Average thiamine levels were not low in both pre-hemodialysis (50.1 ± 75.9 ng/mL; normal range 24 - 66 ng/mL) and post-hemodialysis (56.4 ± 61.7 ng/mL). In 18 patients, post-hemodialysis levels of thiamine were lower than pre-hemodialysis levels. We divided the patients into two groups, the decrease (Δthiamine/pre thiamine < 0; - 0.13 ± 0.11) group (n = 18) and the increase (Δthiamine/pre thiamine> 0; 0.32 ± 0.21)) group (n = 82). However, there was no significance between the two groups in Kt/V or type of dialyzer. Patients were dichotomized according to median serum thiamine level in pre-hemodialysis into a high-thiamine group (≥ 35.5 ng/mL) and a low-thiamine group (< 35.4 ng/mL), and clinical characteristics were compared between the two groups. The low-thiamine value group (< 35.4 ng/ml; 26.8 ± 5.3 ng/ml) exhibited lower levels of serum aspartate aminotransferase and alanine aminotransferase than the high-thiamine value group (≥ 35.4 ng/ml; 73.5 ± 102.5 ng/ml) although there was no significance in nutritional marker, Alb, geriatric nutritional risk index , protein catabolic rate and creatinine generation rate. Conclusion: In our regular dialysis patients, excluding a few patients, we did not recognize thiamine deficiency and no significant difference in thiamine value between pre and post hemodialysis.

Overview of blood purification in uremia

1980 ◽  
Vol 3 (4) ◽  
pp. 203-208
Author(s):  
B.T. Burton
Keyword(s):  
Renal Failure ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Rejection Rate ◽  
Blood Purification ◽  
Maintenance Hemodialysis ◽  
Dialysis Patients ◽  
Transplant Patients ◽  
Maintenance Dialysis ◽  
Transplanted Kidneys

Today, management of irreversible renal failure is based primarily on maintenance hemodialysis and renal transplantation with a growing minority of patients treated by peritoneal dialysis. With regard to renal transplantation — the early promise of renal transplantation in the mid 1960's has given way to the realities of the late 1970's. There have been no major changes in the rejection rate of transplanted kidneys in recent years though today's mortality of transplant patients is considerably reduced over what it used to be. Moreover, universally the lack of availability of a sufficient number of organs for transplantation poses a formidable problem. It is all too apparent that current methods of blood purification in uremia are far from optimal. Even though the mortality in maintenance dialysis is relatively low, hemodialysis is characterized by a variety of complications and most maintenance dialysis patients are not optimally rehabilitated.

scholarly journals Evaluation of handgrip strength as a nutritional marker and prognostic indicator in peritoneal dialysis patients

2005 ◽  
Vol 81 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Angela Yee-Moon Wang ◽  
Mandy Man-Mei Sea ◽  
Zoe So-Ying Ho ◽  
Siu-Fai Lui ◽  
Philip Kam-Tao Li ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Handgrip Strength ◽  
Prognostic Indicator ◽  
Dialysis Patients ◽  
Nutritional Marker

Peak Torque Prediction Using Handgrip and Strength Predictors in Men and Women With Motor Complete Spinal Cord Injury

2021 ◽  
Vol 27 (3) ◽  
pp. 49-59
Author(s):  
Frederico Ribeiro Neto ◽  
Jefferson Rodrigues Dorneles ◽  
João Henrique Carneiro Leão Veloso ◽  
Carlos Wellington Gonçalves ◽  
Rodrigo Rodrigues Gomes Costa
Keyword(s):  
Handgrip Strength ◽  
Peak Torque ◽  
Shoulder Abduction ◽  
Trunk Flexion ◽  
Predictive Equations ◽  
Men And Women ◽  
Flexion Extension ◽  
Cord Injury ◽  
Complete Spinal Cord Injury ◽  
Hand Dynamometry

Objectives: To establish predictive equations for peak torque of muscle groups with totally and partially preserved innervation in individuals with motor complete spinal cord injury (SCI), based on hand dynamometry and strength predictor variables. Methods: The cross-sectional study conducted at a rehabilitation hospital consecutively recruited 108 men and women with SCI. All participants performed maximum peak torque tests for shoulder abduction/adduction (isokinetic), trunk flexion/extension (isometric), and handgrip strength testing (hand dynamometer) to establish predictive peak torque equations. The primary outcomes were peak torque variables. Handgrip strength, age, injury level, time since injury, age at injury, body mass, height, body mass index, and physical activity level were the secondary outcomes used as strength predictor variables. Results: Handgrip strength was a predictor variable for shoulder abduction/adduction peak torque. The best predictive models for shoulder abduction/adduction peak torque exhibited R2 = 0.57 and R2 = 0.60, respectively (p ≤ .05). Injury level showed the highest significant predictive capacity for trunk flexion/extension peak torque models (R2 = 0.38 and R2 = 0.29; p ≤ .05). Conclusion: Shoulder abduction/adduction peak torque predictive equations may be an alternative for use in an accessible strength tool (hand dynamometry) to evaluate training and rehabilitation programs. Trunk flexion/extension peak torque equations exhibited moderate correlations and high standard error of the estimates and should be used with caution.

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