Patient-reported difficulty in activities of daily living and corresponding muscle weakness in elderly patients undergoing haemodialysis.

AIM: Patients undergoing haemodialysis have reduced muscle strength and impaired activities of daily living (ADL). We examined possible relationship between difficult ADL and corresponding muscle weakness in elderly haemodialysis patients. METHODS: This was a single-centre, cross-sectional study. Patient-reported ADL difficulty was examined using a questionnaire in six ADL using upper limbs (eating, grooming and dressing) and lower limbs (bathing, toileting and locomotion). We measured six muscle strengths by dynamometers of shoulder flexion, shoulder abduction, elbow flexion, handgrip, hip abduction and knee extension. The muscle strength with the lowest Z-score was considered as the weakest muscle strength for the patient. RESULTS: The six scores of ADL difficulty were all inversely associated with the six muscle strengths in the 81 total participants of whom 71 individuals (87.7%) had any ADL difficulty. Among the six measurements of muscle strength, handgrip strength showed the highest associations with all ADL difficulties. In 25 patients who perceived that the most difficult ADL was an activity using upper limbs, the common weakest muscle strengths were the hip abduction, handgrip and elbow flexion. In 44 patients who perceived that the most difficult ADL was an activity using lower limbs, knee extension was the most prevalent weakest muscle strength. CONCLUSION: This study suggested preferential relationship between the most difficult ADL and corresponding muscle weakness in elderly haemodialysis patients. This finding may be useful in prevention and treatment.

Reproducibility of quantitative ADC, T1, and T2 measurement on the cerebral cortex: Utility of whole brain echo-planar DWI with compressed SENSE (EPICS-DWI): A pilot study.

Purpose: To assess the reproducibility of ADC, T1, T2, and proton density (PD) measurements on the cortex across the entire brain using high-resolution pseudo-3D diffusion-weighted imaging using echo-planar imaging with compressed SENSE (EPICS-DWI) and 3D quantification with an interleaved Look-Locker acquisition sequence with T2 preparation pulse (3D-QALAS) in normal healthy adults. Methods: Twelve healthy participants (median age, 33 years; range, 28-51 years) were recruited to evaluate the reproducibility of whole-brain EPICS-DWI and synthetic MRI. EPICS-DWI utilizes a compressed SENSE reconstruction framework while maintaining the EPI sampling pattern. The 3D-QALAS sequence is based on multi-acquisition 3D gradient echo, with five acquisitions equally spaced in time, interleaved with a T2 preparation pulse and an inversion pulse. EPICS-DWI (b values, 0 and 1000 s/mm2) and 3D-QALAS sequence with identical voxel size on a 3.0-T MR system were performed twice (for test-retest scan). Intraclass correlation coefficients (ICCs) for ADC, T1, T2, and PD for all parcellated volume of interest (VOI) per subject on scan-rescan tests were calculated to assess reproducibility. Bland-Altman plots were used to investigate discrepancies in ADCs, T1s, T2s, and PDs obtained from the two MR scans. Results: The ICC of ADCs was 0.785, indicating "good" reproducibility. The ICCs of T1s, T2s, and PDs were 0.986, 0.978, and 0.968, indicating "excellent" reproducibility. Conclusion: The combination of EPICS-DWI and 3D-QALAS sequences with identical voxel size could reproducible ADC, T1, T2, and PD measurements for the cortex across the entire brain in healthy adults.