Walking and talking in maintenance hemodialysis patients

Arch Phys Med Rehabil. 2013 Jan;94(1):127-31. doi: 10.1016/j.apmr.2012.07.015. Epub 2012 Jul 31.


Objectives: To investigate whether there is a reduction in walking with the simultaneous performance of a cognitive task (ie, dual-task cost [DTC]) in persons undergoing hemodialysis (HD), and whether it is greater in persons undergoing HD compared with age-matched controls.

Design: Cohort.

Setting: University research laboratory.

Participants: Persons undergoing HD (n=14; 5 women, 9 men; mean age ± SD, 50.0±11.8y) and age-matched controls (n=14; 4 women, 10 men; mean age ± SD, 48.5±10.1y) participated in the investigation.

Interventions: Not applicable.

Main outcomes measures: Participants walked at a self-selected pace on an electronic pathway, which recorded spatiotemporal parameters of gait, in 4 separate trials and completed a cognitive task in the last 2 trials. The DTC was quantified as the change in spatiotemporal parameters of gait from baseline to the cognitive trials.

Results: The HD group had a greater decrease in walking function during the cognitive task, with DTC ranging from 6% to 14%. On average, walking velocity decreased to less than 1m/s in HD patients during the cognitive condition. Baseline walking velocity was found to be moderately correlated with the magnitude of DTC of cadence and step time (ρ=-.44 and .46; P values <.05).

Conclusions: Persons undergoing HD have greater interference between walking and talking compared with controls. Difficulty walking while thinking has implications for everyday life and may be related to the risk of falls. Further work is necessary to determine other contributing factors to elevated DTC in HD patients, and whether DTC can be reduced with targeted interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Case-Control Studies
  • Female
  • Humans
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Speech / physiology*
  • Task Performance and Analysis*
  • Walking / physiology*