Postural control in hemodialysis patients

- Postural control in persons undergoing hemodialysis was compared to healthy controls.
- We examine changes in posture as function of concurrent cognitive task.
- Persons undergoing hemodialysis have greater postural sway in quiet standing.
- Persons undergoing hemodialysis have greater decline with concurrent cognitive task.
- Results inform interventions focusing on improvement of posture in this population.

The current investigation examined whether patients undergoing hemodialysis (HD) have reduced standing postural control performance during simultaneous cognitive task performance (i.e. dual task cost (DTC)) compared to age-gender matched controls. 19 persons undergoing HD and 19 age, gender, and body mass index (BMI) matched controls participated in the investigation. All participants performed 2 trials of quiet standing balance and 2 postural trials in which they performed a cognitive task. Postural control was indexed with various measures of the center of pressure (COP) trajectory. The change in postural control with a cognitive task (e.g. dual task cost DTC) was quantified as a change in the center of COP parameters of postural control from quiet standing to the cognitive condition.The primary observations were that (1) HD patients had significantly greater postural sway than age, gender, BMI matched controls (p's < 0.05); (2) HD patients had a greater DTC than the controls during quiet standing (p's < 0.05). The observations highlight that HD participants have poor postural control that is further exacerbated by a simultaneous performance of a cognitive task. It is possible that this impaired postural control places HD participants at elevated fall risk. Further study is necessary to determine contributing factors to an increased DTC in this population and whether targeted interventions such as exercise can reduce DTC.