Comparação de resultados de testes de desempenho físico e força muscular nos momentos pré e pós sessão de hemodiálise

Abstract

Introduction: Assessment of physical function in hemodialysis patients is important to identify and treat functional loss, which is associated with worse quality of life and poor outcomes. Pre and post hemodialysis, some common symptoms can alter the results of these tests. Therefore, the objective of this study was to verify the agreement of physical function assessment tests between the pre and post hemodialysis moments. Methods: Observational study that included adult hemodialysis patients. Assessment of physical function was mesured using the Short Physical Performance Battery (SPPB), gait speed and Timed Up and Go (TUG) sit-stand test and Handgrip Strength (HGS). All tests were performed on the same day, before and after the dialysis session. Reproducibility between pre and post tests was assessed using the intraclass correlation coefficient. Bland–Altman plots, with mean of differences (MD) and limits of agreement (LOA), were plotted to evaluate agreement between tests. Results: 54 patients were enrolled, 59.3% male, age mean 58±13 years. The results of all tests were significantly better in pre-dialysis moment. Reproducibility between moments varied from moderate to excellent. However, based on the Bland Altman graphs, there was no good agreement between the tests in the pre and post hemodialysis moments. In general, the MD were small, but the LOA were considered high (SPPB: MD=-1.1; LOA=-4.1–1.9; TUG: MD=2.4; LOA=-3.9–8.8; FPM: MD=-0.9; LOA=-6.0–4.3, VM: MD=-0.09; LOA=-0.34–0.16; SL: MD=1.7; LOA=-4.0–7.4). Conclusion: Results of physical function tests did not agree between the pre and post hemodialysis moments and were better in the pre-hemodialysis moment. We suggest that testing should be standardized before hemodialysis.