Tobia Zanotto1, Stefano Gobbo2, Valentina Bullo2, Barbara Vendramin2, Enrico Roma2, Federica Duregon2, Danilo Sales Bocalini3, Andrea Di Blasio4, Lucia Cugusi5, Lucrezia Furian6, Caterina Di Bella6, Daniel Neunhaeuserer2, Francesca Battista2, Marco Bergamin7, Andrea Ermolao2. 1. Centre of Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, EH21 6UU, United Kingdom. 2. Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy. 3. Laboratorio de Fisiologia e Bioquimica Experimental, Centro de Educacao Fisica e Deportos, Universidade Federal do Espirito Santo (UFES), Vitoria, ES, Rua Vergueiro, 235, Liberdade, Sao Paulo, SP, 01504-00, Brazil. 4. Department of Medicine and Sciences of Aging, G. d'Annunzio University of Chieti-Pescara IT, Italy. 5. Department of Medical Sciences 'M. Aresu', University of Cagliari IT, SS 554 - 09042, Monserrato, CA, Italy. 6. Kidney and Pancreas Transplant Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Via Giustiniani 2, 35128 Padova, Italy. 7. Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Via Giustiniani, 2, 35128, Padova, Italy. Electronic address: marco.bergamin@unipd.it.
Abstract
BACKGROUND: End-stage renal disease patients living with a kidney transplant (KT) often present with frailty, functional disability, and mobility impairments that may result in a high risk of falls. Postural balance and muscle strength are implicated in the etiology of falls in the geriatric population, and both may be impaired in KT patients. RESEARCH QUESTION: We conducted a cross-sectional investigation to estimate the prevalence of falls, as well as to explore the association between postural balance, muscle strength and history of falls in end-stage renal disease patients living with a KT. METHODS: Fifty-nine prevalent KT patients (age = 53.2 ± 11 years) were enrolled in this cross-sectional study. Participants were classified as fallers/non-fallers and underwent an objectively-measured assessment of postural balance on a stabilometric platform in eyes open (EO), eyes closed (EC), and dual-task (DT) conditions. Center of pressure (CoP) variables were taken for the analysis. In addition, participants underwent isometric (IM) and isokinetic (IK) assessments of lower limb muscle strength on a multi-joint evaluation system. RESULTS: Thirty-four percent of the study participants reported at least one fall in the previous 12 months. In logistic regression analysis, CoP velocity in EO (OR: 1.23, 95 % CI: 1.06-1.43, p = .007), and IK ankle dorsiflexion strength (OR: 0.87, 95 % CI: 0.77-0.99, p = .034) were independently associated with increased odds of falling. SIGNIFICANCE: This cross-sectional study indicates that patients living with a KT presented with a prevalence of falls indicative of a high risk of falling. Postural balance and muscle strength are exercise-modifiable factors and further research is warranted to establish to what extent these measures may be implicated in the etiology of falling in this patient group.
BACKGROUND:End-stage renal diseasepatients living with a kidney transplant (KT) often present with frailty, functional disability, and mobility impairments that may result in a high risk of falls. Postural balance and muscle strength are implicated in the etiology of falls in the geriatric population, and both may be impaired in KT patients. RESEARCH QUESTION: We conducted a cross-sectional investigation to estimate the prevalence of falls, as well as to explore the association between postural balance, muscle strength and history of falls in end-stage renal diseasepatients living with a KT. METHODS: Fifty-nine prevalent KT patients (age = 53.2 ± 11 years) were enrolled in this cross-sectional study. Participants were classified as fallers/non-fallers and underwent an objectively-measured assessment of postural balance on a stabilometric platform in eyes open (EO), eyes closed (EC), and dual-task (DT) conditions. Center of pressure (CoP) variables were taken for the analysis. In addition, participants underwent isometric (IM) and isokinetic (IK) assessments of lower limb muscle strength on a multi-joint evaluation system. RESULTS: Thirty-four percent of the study participants reported at least one fall in the previous 12 months. In logistic regression analysis, CoP velocity in EO (OR: 1.23, 95 % CI: 1.06-1.43, p = .007), and IK ankle dorsiflexion strength (OR: 0.87, 95 % CI: 0.77-0.99, p = .034) were independently associated with increased odds of falling. SIGNIFICANCE: This cross-sectional study indicates that patients living with a KT presented with a prevalence of falls indicative of a high risk of falling. Postural balance and muscle strength are exercise-modifiable factors and further research is warranted to establish to what extent these measures may be implicated in the etiology of falling in this patient group.
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