HEMODİYALİZ TEDAVİSİ GÖREN KRONİK BÖBREK YETMEZLİĞİ OLAN HASTALARDA EL KAVRAMA GÜCÜ İLE FİZİKSEL AKTİVİTE ENGELLERİ ARASINDAKİ İLİŞKİ

Öz

Amaç: Bu çalışma, hemodiyaliz alan kronik böbrek hastalığı (KBH) olan hastalarda el kavrama kuvveti (EKK) ile fiziksel aktivite engelleri arasındaki ilişkiyi araştırmayı amaçladı. Yöntem: Kesitsel ve tanımlayıcı tipteki bu çalışma, Türkiye’nin güneyindeki bir hastanenin hemodiyaliz ünitesinde tedavi gören 78 KBH hastası ile yürütüldü. Veri toplamak için bireysel bilgi formu, fiziksel aktivite engelleri ölçeği ve dijital el dinamometresinden elde edilen EKK sonuçları kullanıldı. Bulgular: Katılımcıların yaş ortalaması 56,85±12,17 olup, kadın ve erkek sayısı eşittir. Erkeklerin ve çalışan hastaların EKK diğerlerine göre daha yüksekti (p<0,05). Evli, kadın, okuryazar/ilkokul mezunu, geliri giderinden az olan ve çalışmayan bireylerde fiziksel aktivite engellerinin daha yüksek olduğu belirlendi (p<0,05). Ayrıca katılımcıların EKK ile fiziksel aktivite engelleri ilişkiliydi (r=-0,246, p<0,05). Sonuç: Bu çalışma, hemodiyaliz alan KBH hastalarında düşük EKK ile yüksek fiziksel aktivite engelleri arasında zayıf bir ilişki olduğunu ortaya koymuştur. Özellikle kadınların, evli bireylerin, düşük eğitim veya gelir düzeyine sahip olanların daha fazla fiziksel aktivite engeliyle karşılaştığı görüldü. Artan yaş ve vücut kütle indeksi, engellerin yükselmesiyle ilişkilendirilirken, çalışan hastalar daha iyi EKK sergiledi. Bu bulgular, bu popülasyonda fiziksel aktiviteyi iyileştirmek için sosyo-ekonomik ve klinik faktörlere yönelik hedefli müdahalelerin gerekliliğini vurgulamaktadır.

Anahtar Kelimeler

• Kronik böbrek hastalığı
• Kas gücü
• Hemodiyaliz
• Fiziksel aktivite engelleri

THE RELATIONSHIP BETWEEN HANDGRIP STRENGTH AND PHYSICAL ACTIVITY BARRIERS IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING HEMODIALYSIS

Abstract

Purpose: The aim of this study is to investigate the relationship between handgrip strength (HGS) and physical activity barriers in patients with chronic kidney disease (CKD) undergoing hemodialysis. Methods: This cross-sectional and descriptive study was conducted with 78 patients with CKD receiving treatment in the hemodialysis unit of a hospital located in southern Türkiye. An individual information form, the Physical Activity Barriers Questionnaire and HGS results obtained from a digital hand dynamometer were used to collect data. Results: The participants had a mean age of 56.85±12.17 years, with an equal distribution of males and females. The HGS values of male and employed patients were higher than the values of the others (p<0.05). The physical activity barriers were higher in those who were married, female, literate/primary school graduate, unemployed and had an income less than their expenses (p<0.05). Moreover, participants’ HGS was associated with their physical activity barriers (r=-0.246, p<0.05). Conclusion: This study revealed weak correlations between lower HGS and higher physical activity barriers in CKD patients undergoing hemodialysis. CKD patients who were female, married, and had a lower education or income level in particular faced greater physical activity barriers. Higher age and body mass index were associated with increased barriers, while employed patients had better HGS. These findings highlight the need for targeted interventions addressing socio-economic and clinical factors to improve physical activity in this population.

Keywords

• Chronic kidney disease
• Handgrip strength
• Hemodialysis
• Physical activity barriers

References

1. Levey AS, Becker C, Inker LA. Glomerular filtration rate and albuminuria for detection and staging of acute and chronic kidney disease in adults: a systematic review. JAMA. 2015;313(8):837-46.
2. Tsai YC, Chen HM, Hsiao SM, Chen CS, Lin MY, Chiu YW, et al. Association of physical activity with cardiovascular and renal outcomes and quality of life in chronic kidney disease. PLoS One. 2017;12(8):e0183642.
3. Lambert K, Lightfoot CJ, Jegatheesan DK, Gabrys I, Bennett PN. Physical activity and exercise recommendations for people receiving dialysis: a scoping review. PLoS One. 2022;17(4):e0267290.
4. Jayaseelan G, Bennett PN, Bradshaw W, Wang W, Rawson H. Exercise Benefits and barriers: the perceptions of people receiving hemodialysis. Nephrol Nurs J. 2018;45(2):185-219.
5. Johansen KL, Chertow GM, Kutner NG, Dalrymple LS, Grimes BA, Kaysen GA. Low level of self-reported physical activity in ambulatory patients new to dialysis. Kidney Int. 2010;78(11):1164-70.
6. Tentori F, Elder SJ, Thumma J, Pisoni RL, Bommer J, Fissell RB, et al. Physical exercise among participants in the Dialysis Outcomes and Practice Patterns Study (DOPPS): correlates and associated outcomes. Nephrol Dial Transplant. 2010;25(9):3050-62.
7. Darawad MW, Khalil AA. Jordanian dialysis patients’ perceived exercise benefits and barriers: a correlation study. Rehabil Nurs. 2013;38(6):315-22.
8. Lightfoot CJ, Wilkinson TJ, Song Y, Burton JO, Smith AC. Perceptions of exercise benefits and barriers: the influence on physical activity behaviour in individuals undergoing haemodialysis and peritoneal dialysis. J Nephrol. 2021;34(6):1961-71.

9. Rosa CS, Bueno DR, Souza GD, Gobbo LA, Freitas IF Jr, Sakkas GK, et al. Factors associated with leisure-time physical activity among patients undergoing hemodialysis. BMC Nephrol. 2015;16(1):192.
10. Clarke AL, Young HM, Hull KL, Hudson N, Burton JO, Smith AC. Motivations and barriers to exercise in chronic kidney disease: a qualitative study. Nephrol Dial Transplant. 2015;30(11):1885-92.
11. Kendrick J, Ritchie M, Andrews E. Exercise in Individuals With CKD: a focus group study exploring patient attitudes, motivations, and barriers to exercise. Kidney Med. 2019;1(3):131-8.
12. Cavill NA, Foster CEM. Enablers and barriers to older people’s participation in strength and balance activities: a review of reviews. J Frailty Sarcopenia Falls. 2018;3(2):105-13.
13. Yoshioka M, Kosaki K, Matsui M, Takahashi K, Shibata A, Oka K, et al. Physical activity, sedentary behavior, and skeletal muscle strength in patients with chronic kidney disease: an isotemporal substitution approach. Phys Ther. 2021;101(7):pzab101.
14. Leal VO, Mafra D, Fouque D, Anjos LA. Use of handgrip strength in the assessment of the muscle function of chronic kidney disease patients on dialysis: a systematic review. Nephrol Dial Transplant. 2011;26(4):1354-60.
15. Bohannon RW, Wang YC, Yen SC, Grogan KA. Handgrip strength: a comparison of values obtained from the NHANES and NIH toolbox studies. Am J Occup Ther. 2019;73(2):7302205080p1-9.
16. Cheng Y, Liu M, Liu Y, Xu H, Chen X, Zheng H, et al. Chronic kidney disease: prevalence and association with handgrip strength in a cross-sectional study. BMC Nephrol. 2021;22(1):246.
17. Stevens KI, Graham-Brown M, Lees JS. Let’s get physical: considering and overcoming the barriers to physical activity in CKD. Nephrol Dial Transplan. 2023;38(6):1405-7.
18. Fiaccadori E, Sabatino A, Schito F, Angella F, Malagoli M, Tucci M, et al. Barriers to physical activity in chronic hemodialysis patients: a single-center pilot study in an Italian dialysis facility. Kidney Blood Press Res. 2014;39(2-3):169-75.
19. Yurtçiçek S, Hotun Şahin N, Miral M. The study of the validity and reliability of the Turkish version of physical activity barriers questionnaire. J Acad Soc Sci. 2018;6(71):396-404.
20. Ibrahim S, Karim NA, Oon NL, Ngah WZ. Perceived physical activity barriers related to body weight status and sociodemographic factors among Malaysian men in Klang Valley. BMC Public Health. 2013;13(1):275.
21. Pinto AP, Ramos CI, Meireles MS, Kamimura MA, Cuppari L. Impact of hemodialysis session on handgrip strength. J Bras Nefrol. 2015;37(4):451-7.
22. Richardson JTE. Eta squared and partial eta squared as measures of effect size in educational research. Educ Res Rev. 2011;6(2):135-47.
23. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-8.
24. Debnath S, Rueda R, Bansal S, Kasinath BS, Sharma K, Lorenzo C. Fatigue characteristics on dialysis and non-dialysis days in patients with chronic kidney failure on maintenance hemodialysis. BMC Nephrol. 2021;22(1):112.
25. Moorman D, Suri R, Hiremath S, Jegatheswaran J, Kumar T, Bugeja A, et al. Benefits and barriers to and desired outcomes with exercise in patients with ESKD. Clin J Am Soc Nephrol. 2019;14(2):268-76.
26. Ghafourifard M, Mehrizade B, Hassankhani H, Heidari M. Hemodialysis patients perceived exercise benefits and barriers: the association with health-related quality of life. BMC Nephrol. 2021;22(1):94.
27. Gerovasili V, Agaku IT, Vardavas CI, Filippidis FT. Levels of physical activity among adults 18-64 years old in 28 European countries. Prev Med. 2015;81:87-91.
28. Cai Lian T, Bonn G, Si Han Y, Chin Choo Y, Chee Piau W. Physical activity and its correlates among adults in Malaysia: a cross-sectional descriptive study. PLoS One. 2016;11(6):e0157730.
29. Kaur J, Kaur G, Ho BK, Yao WK, Salleh M, Lim KH. Predictors of physical inactivity among elderly malaysians: recommendations for policy planning. Asia Pac J Public Health. 2015;27(3):314-22.
30. Calogiuri G, Elliott LR. Why do people exercise in natural environments? Norwegian adults’ motives for nature-, gym-, and sports-based exercise. Int J Environ Res Public Health. 2017;14(4):377.
31. Zelle DM, Klaassen G, van Adrichem E, Bakker SJ, Corpeleijn E, Navis G. Physical inactivity: a risk factor and target for intervention in renal care. Nat Rev Nephrol. 2017;13(3):152-68.
32. Villanego F, Naranjo J, Vigara LA, Cazorla JM, Montero ME, García T, et al. Impact of physical exercise in patients with chronic kidney disease: systematic review and meta-analysis. Nefrol (Engl Ed). 2020;40(3):237-52.
33. Farragher JF, Polatajko HJ, McEwen S, Jassal SV. A proof-of-concept investigation of an energy management education program to improve fatigue and life participation in adults on chronic dialysis. Can J Kidney Health Dis. 2020;7:2054358120916297.
34. Regolisti G, Maggiore U, Sabatino A, Gandolfini I, Pioli S, Torino C, et al. Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients: a quantitative assessment. PLoS ONE. 2018;13(4):e0196313.
35. Baillot A, Chenail S, Barros Polita N, Simoneau M, Libourel M, Nazon E, et al. Physical activity motives, barriers, and preferences in people with obesity: a systematic review. PLoS One. 2021;16(6):e0253114.