Physical function of outpatients and inpatients on dialysis who received physical therapy: an exploratory, crosssectional study by JSPTDM

ABSTRACT Objective: Hospitalization for conditions including cardiovascular diseases,infections, orthopedic diseases, and cerebrovascular diseases is responsible for the decline in activities of daily living (ADLs) in patients on dialysis. Rehabilitation during hospitalization helps these patients recover their physical function, resume ADL, and ultimately resume regular outpatient dialysis. However, the actual physical condition of patients on dialysis who are prescribed and require physical therapy has not been reported. Hence, we elucidated the actual physical condition of outpatients and inpatients on dialysis who were prescribed physical therapy. Methods: This retrospective, multicenter, cross-sectional survey included dialysis patients who received hemodialysis or hemodiafiltration and underwent physical therapy. We investigated the following physical functions: knee extensor strength, grip strength, and short physical performance battery. The number of patients with physical function below the reference values was also examined. Moreover, we investigated the patients’ demographic data and blood biochemistry tests. Descriptive statistics were used to analyze the survey items. Comparisons were conducted using the chi-squared and Mann-Whitney U tests. Results: Altogether, 116 patients were included in the analysis; 90 were outpatients and 26 were inpatients. Analysis of the demographic data revealed that the inpatients had a significantly higher percentage of concomitant cardiovascular disease, lower extremity arterial disease, and diabetic neuropathy than the outpatients. The percentage of patients whose results were lower than the reference values for knee extender strength, grip strength, and SPPB was greater than 80% in the inpatients and approximately 50% in the outpatients. Conclusion: More than half of the dialysis patients in this study had a poor functional status, which was defined as equivalent levels of frailty and sarcopenia. The physical function of inpatients was particularly low.