RESEARCH REPORT POSTER DISPLAY

SERUM CREATININE CONCENTRATION MAY BE USED AS A PREDICTOR FOR DECREMENT OF LOWER LIMB FUNCTIONS IN ALS PATIENTS . Kamide N¹, Hiraga Y², Kasuga M², Fujihashi N², Yamazaki T², Miyagi S², Ando F², Sumida S², Ogino M³, Fukuda M^1,2, Maeda Y⁴; ¹Kitasato University, School of Allied Health Sciences. ²Kitasato University East Hospital, Department of Rehabilitation. ³Kitasato University, School of Medicine, Department of Neurology. ⁴Kanto Rehabilitation College

PURPOSE: This study investigated the relationship between serum creatinine concentration and lower limb functions in patients with amyotrophic lateral sclerosis (ALS). RELEVANCE: Because, supply of care for ALS patients should precede progression of disease, prediction of decrement of lower limb functions is an important theme for physical therapists who are caring them. PARTICIPANTS: Subjects included in this study were, fifteen patients diagnosed as ALS whose disease progression had been followed at primary care hospital. Subject characteristics were, average age 66.3±9.3 years, average disease duration 3.8±3.6 years, types of disease onset 2 bulbar and 13 limbs, of which 8 had bulbar symptom and 7 did not when the study was carried out. METHODS: A serum creatinine concentration was selected from blood samples data. Manual muscle testing (MMT) that was conducted on iliopsoas, quadriceps femoris and tibialis anterior muscle, and gross motor; a subscale of revised ALS functional rating scale (ALSFRS-R), were measured to evaluate lower limb functions. The gross motor consist of the following items: (1) turning in bed, (2) walking, and (3) climbing stairs. All data described above were collected from medical records and were investigated on cross-section. The protocol of this study conformed to the Helshinki Declaration. ANALYSIS: Spearman’s correlation coefficients were carried out to determine the relationship between a serum creatinine concentration and muscle strength, gross motor. Statistical significance was set at 5%. RESULTS: An average of a serum creatinine concentration was 0.49±0.15 mg/dl in this study’s patients. Significant positive correlations were found between a serum creatinine concentration and quadriceps femoris muscle strength (r = 0.76, p < 0.01), climbing stairs (r = −0.57, p < 0.05). In addition, positive correlations tendency were found between a serum creatinine concentration and ilipsoas muscle strength (r = 0.48, p < 0.08), turning in bed (r = 0.50, p < 0.06). CONCLUSIONS: It was suggested that decrease of a serum creatinine concentration is associated to decrease of lower limb functions, which were represented by muscle strength and gross motor. IMPLICATIONS: In clinical practice, if physical therapists pay attention to changes in serum creatinine concentration, it may be possible to predict the decrease of lower limb functions in patients with ALS. KEYWORDS: amyotrophic lateral sclerosis, serum creatinine concentration, lower limb functions. FUNDING ACKNOWLEDGEMENTS: This study was not funded. CONTACT: naokami@kitasato-u.ac.jp