The Impact of Hemodialysis on Spatio-Temporal Characteristics of Gait and Role of Exercise: A Systematic Review

Background: People with end-stage kidney disease (ESKD) on hemodialysis (HD) commonly have functional impairments. The purpose of this systematic review was to evaluate the effect of HD on spatio-temporal characteristics of gait, and effect of exercise on these parameters. Methods: Electronic databases were searched to identify relevant citations. Extracted data was computed using a random effects model for means (Hedges' and 95% confidence interval (CI). Results: 27 studies met inclusion criteria. Mean values: gait speed (GS)-1.0 m/s (CI: 0.9-1.1 m/s; 16 studies), fast walking speed (FWS)-1.5 m/s (CI: 1.3-1.6 m/s; 7 studies), timed get-up & go test (TUG) -6.8 s (CI: 6.1-7.5 s; 2 studies), walk tests (WT) 193.0 s (CI: 116.0-270.0; 5 studies), 6 min-walk-test (6MWT)-386.6 m (CI: 243.2-530.0 m; 11 studies). 4 studies compared participants on HD with normal controls and 10 studies evaluated the effect of nutrition/exercise. Conclusions: Compared to age-matched populations, people with ESKD/HD had significantly slower GS and reduced walk distances; with intervention, the change in the distance walked was significant. Further research is required to evaluate the effect of HD on gait parameters, and the type of exercise/nutrition that will lead to meaningful changes.