Older patients being evaluated for kidney transplantation may soon be screened for hidden mobility problems with a short, standardized physical test, according to a study published in BMC Nephrology. Researchers found that the Short Physical Performance Battery, a widely used measure of lower-extremity function, performed well in identifying which older candidates needed a full physiotherapy workup for locomotor disorders.
The study addressed a practical gap in pre-transplant care. Locomotor disorders, which affect balance, gait and strength, are common with ageing and are particularly frequent in patients with chronic kidney disease. In the context of kidney transplantation, these disorders are associated with numerous complications, making their detection before surgery an important part of patient preparation. Yet the comprehensive physiotherapy assessment used to characterize them is resource-intensive, and clinicians have lacked a validated way to decide which patients truly require it.
To test whether a simpler tool could do that job, the researchers conducted a retrospective observational study of patients aged 65 years or older with end-stage chronic kidney disease who were referred for pre-kidney transplantation assessment. A total of 217 patients were included, with a mean age of 73.5 years and a standard deviation of 3.2 years. Each participant completed both the Short Physical Performance Battery and a comprehensive locomotor assessment.
The comprehensive assessment was considered abnormal if a patient showed impairment in at least one of four established tests: the Timed Up and Go test, the Tinetti test, the 6-minute walk test and the single-leg stance test. These instruments capture different dimensions of mobility, including transfer ability and fall risk, gait and balance quality, walking endurance and static stability. The researchers then asked how accurately the Short Physical Performance Battery, alone or through its sub-scores, could flag patients whose full assessment turned out to be abnormal.
The analysis relied on receiver operating characteristic curves, a standard statistical method for evaluating diagnostic performance. For each possible cut-off score, the method plots sensitivity, the proportion of truly abnormal patients correctly identified, against the false-positive rate. The area under this curve, reported with 95 percent confidence intervals, summarizes overall discriminative ability: a value of 0.5 indicates performance no better than chance, while 1.0 indicates perfect separation of abnormal from normal cases.
The Short Physical Performance Battery achieved an area under the curve of 0.88 (95% CI 0.83–0.94) for identifying an abnormal locomotor assessment. The Short Physical Performance Battery achieved an area under the curve of 0.88, with a 95 percent confidence interval of 0.83 to 0.94, which the authors described as excellent performance in identifying an abnormal locomotor assessment. The SPPB sub-tests also performed well, although their performance remained inferior to that of the total SPPB.
An SPPB threshold score of 10 provided a sensitivity greater than 90%, whereas a score below 8 indicated a specificity greater than 90% for an abnormal locomotor assessment. The authors concluded that the SPPB demonstrated good performance as a screening tool to identify older patients undergoing pre-KT assessment who may require comprehensive physiotherapy assessment, supporting a more targeted use of specialized assessment resources.
The individual sub-tests of the battery also performed well, but their performance remained inferior to that of the total score.
The authors concluded that the Short Physical Performance Battery demonstrated good performance as a screening tool for identifying older patients undergoing pre-kidney transplantation assessment who may require comprehensive physiotherapy assessment. Such targeted screening could support a more efficient use of specialized assessment resources in transplant programs.
Subject of Research: Screening older chronic kidney disease patients for locomotor disorders during pre-kidney transplantation assessment using the Short Physical Performance Battery
Article Title: Performance of a screening strategy for identifying locomotor disorders in older patients during pre-kidney transplantation assessment
Article References: Lerouge, R., Stefan, D.-E., Guerville, F., Coste, M.-H., Novais, T., Vernaudon, J., Montredon, C., & Garnier-Crussard, A. (2026). Performance of a screening strategy for identifying locomotor disorders in older patients during pre-kidney transplantation assessment. BMC Nephrology. https://doi.org/10.1186/s12882-026-05482-z
Image Credits: AI Generated
DOI: 10.1186/s12882-026-05482-z
Keywords: kidney transplantation, Short Physical Performance Battery, locomotor disorders, chronic kidney disease, older adults, physiotherapy assessment, screening tool, Timed Up and Go test, Tinetti test, 6-minute walk test, ROC analysis, pre-transplant evaluation
News Source: Ophelia Keating. (November 6, 2026). Simple Physical Test Flags Hidden Mobility Problems in Older Kidney Transplant Candidates. Scienmag.
