Upper extremities function in patients undergoing hemodialysis treatment

OBJECTIVE: To determine the effects of hemodialysis treatment on upper extremities functional ability.

METHODS: This study was carried out from June 2003 to March 2004 at Pamukkale University School of Physical Therapy, Denizli, Turkey. One hundred patients with chronic renal failure (CRF) undergoing hemodialysis treatment for at least 2 months participated in the study, and were compared with a control group (N=40 healthy subjects). The 100 patients were divided into 4 groups according to the length of hemodialysis duration: 19 patients dialyzing for less than one year (Group 1); 42 patients dialyzing for 1-4 years (Group 2); 21 patients dialyzing for 4.1-8 years (Group 3); 18 patients dialyzing for 8.1 or more years (Group 4). All participants were evaluated for range of motion by goniometry, muscle strength by manual muscle testing, sensation disturbances by Semmes-Weinstein monofilaments, static grip strength by hand dynamometer, and functional status of upper limbs by the Disabilities Arm Shoulder Hand Questionnaire (DASH-T).

RESULTS: The results showed that the patients with CRF had significantly more functional problems associated with CRF and hemodialysis treatment than the healthy controls. In addition to these results, the scores of the DASH-T also showed that the most independent group was the control group with a mean score of 0.72+/-0.86, whereas, the most dependent group was the 3rd group of the hemodialysis groups (mean score of 2.70+/-1.77).

CONCLUSION: Musculoskeletal or functional problems decreasing functional ability of the upper limbs are a common complaint in hemodialysis patients.